Ciro’s Meatball 12/8 conservative NECK; GRAD 2/2/23

Thank you! This makes me feel much better. We will taper Monday and reduce pain dose [mgs? frequency?] and observe. I’ll report back when I know more.

Fingers crossed for a good prednisone taper. When all pain meds have been stopped you will then have accurate proof of pain or no pain in existence.

You can help us out by noting changes with full info of: name of med, mgs dose AND frequency given.

Ciro, best is if Meatball does not have to go on any risky to the healing disc vehicle transports. You have a tricky situation. Best is to play it by ear in making decisions if you would need to keep the 12/29 vehicle transport. Hopefully you can get a plan worked out with local vet to get off the pain meds for proof-positive knowledge of existing pain or no existing pain. The must have directions to taper pred you have. Now you just need to know if you can full stop pain meds or how they should be tapered.

Double check the prednisone bottle intructions.  
Dec 13th post :  "Prednisone 2 weeks on 30mgs, 1 week on 20mg, 1 week on 10mg"

Prednisone
- 30mgs 2x/day for 7 days (anti-inflammatory level dose )
- 20mgs 1x/day for 14 days  This is unusual length for prednisone Rx's
- 10 mgs 1x/day for 7 days
- all prednisone ends with every other day (EOD) doses to signal the body to make its own steroid hormone.  Do you have the EOD dose schedule listed on the bottle?

Usually, a pred taper moves from 1x a day to every other day for a short period of time. That is what is meant by EOD (every other day) dose. Your vet has a taper schedule that does not include an EOD dose.

Different vets use slightly different taper schedules, although most do end with an every other day dose.
Consider checking with your vet about the taper schedule, just to make sure.

I clarified with the vet. He is on 20mg for 14 days, started 12/19. When that is complete, it's 10mg every other day.

I am very sorry to hear that Meatball had a bad day. I hope it is related to undigested food in his stomach as the vet suggested.

If it were my dog, I would have taken him home also. Even if the emergency clinic is completely staffed overnight, they would have many dogs to watch. You will only have Meatball to monitor.

As you know, walking should be as limited as possible. Perhaps helping him stand would get the food moving through the digestive system.

Ciro, now that his digestive tube is working with that regular BM 12/25, the walking around seems like it should be stopped.  Now the top priority is back to getting the disc to heal with limited movement.

There are a number of ways to slow a fast eater down.  Check out the variety of products listed at Amazon and see which could help Meatball or visit your local pet store.

Ciro, it takes 8 weeks of STRICT rest for the disc to heal. STRICT rest means you would be helping to insure there is no increased damage to the the nerves. 

"We are committed to strict crate rest and no walking."

Ciro, how many times a day do you give the 200 mgs of Gabapentin?

There are lots of ways to chill Meatball. See if any one of these will help him to be able to relax in the recovery suite where there is the safety factor of limited movement for his spine.  From the Dodgerslist Website.  I typed in the orange search bar "crate training" and found "Adusting to a recovery suite - emergency training: Helpful tips " : dodgerslist.com/2020/02/24/tips-to-help-with-recovery-suite/

Have you mentioned to your vet if traZODone is not sufficient to calm Meatball. There are other prescription meds for anxiety, it may take trying different ones. Or there could be an adjustment to the traZODone too.

Be mindful that transports for a vet visit are reserved for the most urgent health reasons. Things that can be handled over the phone (med adjustments, updates) keeps Meatball's healing disc at home safe in his recovery suite.  The all important focus in these 8 weeks of rest is to get that disc to heal.  This prevents pain, prevents a potential for nerve damage if too much movement happens (loss of limb, lost bladder control). STRICT rest can avoid an expensive surgery.

What is the urgent purpose of a risk of too much movement transport into a neuro on Jan 26, when graduation day for Meatball is not til Feb 2?

Ciro, think you should discuss with your vet how to handle things.

What is the date for the last dose of EOD prednisone?

Basically the taper to see if inflammation was still there and if yes—— then need to go back up on the anti-inflammatory level dose a bit longer has been kinda messed up.  Pain likely revealed itself not due to the EOD dose but from veering off the strict rest thing.

Also to muddy the waters, both pain meds have been on board for the entire taper time. The taper is to signal the body to make its own steroid hormone. The prednisone steroid taper is also a perfect window to see if pain surfaces indicating not time to taper.  With both gabapentin and methocarbamol on board, you had a blindfold on about pain and could not correctly asses for pain since 12/19! Those two drugs could have been blocking pain....UNTIL there was a release from crate rest to walk around 1/2 and suddenly you notice a stiff uncomfortable neck morning of 1/3.

So the question is should Meatball be back up on the anti-inflammatory level dose of prednisone (30mgs 1x/day) for maybe another 7-day course???  

I recommend alerting your vet to the pain after the walking around 1/2. Your vet will direct you on what to do about each of the meds (anti-flammatory steroid prednisone and the two pain meds (metho and gaba).  Let us know what she says if there are any changes (mgs, frequency and how long on anti-inflammatory level pred.

I know it is hard to comprehend the big picture with a new disease and what/where you need to bone up on on things.  
    Meatball was "seemingly" (because he was still on blindfolding pain meds) was going in the right direction with no pain.  Going in the right direction with a treatment tends to mean the diagnosis was correct and the treatment was the right treatment.  A car transport of too much movement to the disc to a neuro appt could set Meatball back.  Reserve vet appts to only the most urgent of health things that simply can't be taken care of over the phone.  Such as getting a hands on your hands bladder expressing lesson if bladder control would be lost. Not expressing, if it would be needed would invite a dangerous urinary infection (UTI).

 A reason for a consult with a neuro would be
-- if a local vet is not comfortable in using IVDD pain meds to keep a dog out of pain while healing.
-- if a local DVM vet would indicate they are not comfortable with the disease IVDD and say that in so many words by referring to a specialist.

Finger crossed that the Jan 2 bump in the road might could extend the 2/2 graduation date. Let's see what your vet Rx's.  Dogs should be off of all meds for a week or so and no pain showing before graduation day. 

Ciro, would you help us get clarity when you post.
• When possible identify what kind of vet (local DVM vet, neuro vet)
• Avoid using pronouns he, she, it, they.
• Use instead:
--- the receptionist, she said "XYZ"
--- my local DVM vet, said she needs to exam my dog first
• use dates rather than yesterday, today, last week.

So at this point with the house guests gone, Meatball is more relaxed in his suite. And he is NOW pain free round the clock, morning, noon and night?

Call back and relay a message thru the receptionist at your local DVM vet. If it is your vet's day off, then ask to speak to the vet on duty or relay your question. 

YOU ARE NOT asking about prednisone.
YOU WANT to either full stop the pain meds or be given a the way to back them down in mg dose-frequency given.

The point of the taper is to know right away if prednisone would need to be on board back up at the anti-inflammatory dose IF there would be pain surfacing on the taper.  Pain meds block your eyes from accurately and quickly identify if pain would surface.

Keeping pain meds on board during the taper delays finding out if another prednisone course is needed or not.

If the clinic will not help you via a phone call, then it seems you will have to risk a transport in for an appt with your local DVM vet.  Or you can see if you can get in to the Neuro for an appt soonest  BEFORE the taper end on 1/23. The neuro appt will be more expensive and since he's never seen Meatball an exam is required. But at least you will have a vet (a neuro) who has seen Meatball and could be phoned for med adjustments.  

 Fingers crossed this taper will not have any pain surfacing.    Getting off the two pain meds (gaba & metho) expedites finding out that important piece of information. 

Very happy to hear that you think Meatball is pain free. Shaking is sometimes a sign of pain, but it can also be a sign of other things. Since Meatball has always been a shaky dog, it is probably not a sign of pain.

I hope you will be able to move the appointment with the neuro up to next week. I can certainly understand your frustration with your regular DVM.