Sue's Chi 10/30 conservative— Chines Crested Puff

Oh gosh Sue, sorry to hear of another disc episode for Chi.  Kudos to you for immediately crating to prevent worsening of the disc and to keep neuro diminishment relatively mild!!

How much does Chi weigh?

You are the eyes and ears for your vet.  Phone to report pain is not yet being fully managed.  There are 3 sources of pain. And pain meds are effective for 8 hrs.
   Methocarbamol for muscle spasm pain, ask for 3x/day
   gabapentin for nerve pain, ask for 3x/day
   traMADol is the overall analgesic.  Ask for this pain med 3x/day

What was the name of the steroid shot on 10/30?
For how many days is Chi to stay on Dex?
What is the Dex dose in mgs?  
How many mgs does a whole  Dex tablet contain? What part of the tablet do you give 2x/day.

As you may recall from last time, the STRICT rest is to allow the disc to heal and thus prevent worsening of nerve damage.  Keep the mild symptom from getting worse and to let healing go forward.

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

Knowledge is key!
Owner understanding ensures proper conservative treatment principals:
▶︎ Roadmap for your fridge. Stay the course, avoid dangerous detours for the healing disc: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf

Please confirm that we're on the same page as to conservative care—— sounds as if you are, we just like to hear it from your lips.

STRICT rest 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

Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment.  If Chi is going in a good direction of healing, then may be worth reconsidering a car transport on Nov. 14 and all that entails with extra movement of the back. 

Thank you very much for wanting to help us. There are many ways to help.  Check out this page:  dodgerslist.com/aid-effort

Please keep us update on how Chi is doing and what your local vet adjusts for her medications.

Why is Chi on the steroid prednisone?
What date did prednisone start?
How many mgs and how often given ? Since beginning pred, there have been no taper days?

Why is steroid prednisone up on an anti-inflammatory level dose not going to be considered for this disc episode? She has relatively mild symptoms of pain and a degree of leg neuro diminishment.

Dex is one of the more stronger of the steroids. Stronger can mean more potential for stomach damage

You were given 7 Dex steroid pills that contain 0.5mgs of dex?

Sue, good to hear Chi is able to walk better.  Of course she should NOT be walking BUT only taking a very, very few limited footsteps to take care of business, right?  

We read every single word of your post and take what you write literally.   We actually LOVE detail.  "walk better" is general. What are the details?
  -- she is less wobbly
  -- her left paw slips less
  -- her right paw no longer slips at all
  --  other.......? 

I understand the difficulty in writing on a mobile device.  To make things easier make sure you have selected "DESKTOP" mode so the QuICK REPLY area at the bottom of the page will appear. QUICK REPLY is the easiest way to type and scroll back up to look for questions in pink.

Just report pain and let's see what is prescribed.  I gave you the 3 usual meds and the usual times per day they are given to control pain so you  would be aware of what to expect.

Look at the MED LIST below.  in your post only correct what is wrong.
Clarify if Chi had been on prednisone and then your local vet changed to  Dex.  "Chi is on Prednisone This is what she ordered. " 

What date was the final prednisone dose given?

MED LIST. Correct only in your post for things that are incorrect.
    Neuro appt 11/14
    DEX steroid shot given 10/31
    Dex as of 10/31: 0.5 mgs 2x/day for 14 days, then a test taper for: _pain / _neuro
    methocarbamol 125mgs 2x/day
    gabapentin 25mgs 2x/day
    Pepcid AC 5mg 2x/day

NOTE: Give Pepcid AC 30 mins before DEX
          Give DEX with a meal

Your vet has Rx'd Dex because due to the situation she feels it is best to prevent further nerve damage.  

RECAP OF QUESTIONS for your convenience on a mobile device.
1. Clarify if Chi had been on prednisone and then your local vet changed to Dex.
2 What date was the final prednisone dose given? How many mgs? Times per day?
3. What is the date on a Monday for the regular vet appt?
4. What are the details of walking better?
    -- she is less wobbly
    -- her left paw slips less
    -- her right paw no longer slips at all
    -- other.......?

I expect that orthodontist is a typo and Chi has an appointment with an orthopedist. Orthopedists as well as neurologists are specialist that treat IVDD.

Just checking In. Chi seems to be ok. No better and fortunately no worse.

She has had a couple
Of accidents in the crate of urine and sometimes she will come back in and poop. I guess I didn’t have her out long enough. And the urinating was through the night so we

changed her potty schedule
To 6 -12-6-12 give or take
She sometimes lets me know to go out too

She is resting. A lot and drinking a lot of water it seems. She seems to be comfortable and very good about the whole routine.

Maybe it’s the prednisone [?] that’s making her thirsty

I know I thought it was the steroid
I don’t know why I keep calling it Prednisone
Will shoot for every Four hours

Thank you

Sue, it appears from the way write about Dex, that it is starting to taper?
     If the whole dex pill is 0.5mgs and now you are to give 1/2 of a 0.5mg dex tablet that would be a lower dose. 
The taper of dex is the opportunity for you to to monitor for pain.  The confusing part of what you report is that pain meds instead of being stopped have been increased during the taper.  Increasing pain meds further blocks your ability to assess for pain. 
    • traMADol increased to 50mgs from 25mgs 2x/day
    • gabapentin increased to 50 mgs from 25mgs. Which do you actually give: every 8 hrs or every 12 hrs?
    • Did the surgeon observe that Chi was in pain at the appt? 

Sue, do the best you can to monitor for pain. Know it will be a difficult thing as you have a blindfold on with pain meds still on board.  If there  would be pain surfacing, that  would be an indicator it would not be time to be in a taper (not the time to be using lower doses of dex. Immediately alert your vet about any pain during the lowering of of dex.


Thank you for the link to an East Coast LDA hospital.