Jenny's Knox 12/16 conservative- Cockapoo; GRAD 2/10

Jenny, welcome to the Forum. We are glad you are here. Soonest you can register, would be best for helping Knox. Timely communications are important when helping your dog. With registration comes the ability to turn on automatic  email alerts when you have a reply waiting to be read.

Fill us in a bit more so we the sequence events. Perhaps the referral to the neuro would then make sense:

1. What exact symptoms made you take Knox to the vet on  12/15?
2. Since you did not start prednisone pills until 12/16, what did the vet give him on 12/15 in the clinic: Name if a shot, name if a pill?

3. What date was the first lowering (tapering) of prednisone down from the anti-inflammatory level 5mgs twice a day?
4. What did you or the vet observe regarding re-surfacing pain or new/increased neuro diminishment that caused the 12/27 prednisone RX to be back on taper dose of 5mgs ONCE a day?

Was Knox able to do a happy wag when you saw the vet on 12/15
    If Knox can specifically do a happy tail wag when you do happy talk that is a good marker of 
    Did Knox have bladder control on 12/15? or when did bladder control come back?
    If Knox can sniff an old spot in the grass and then make the decision to release urine that is bladder control and it bodes well for more neuro function to take place.

-- There is a classic textbook order that neuro functions self repair in.
-- No one will be able to tell you a timeline or a date to expect nerves to come back whether after a surgery nor with conservative treatment.-- The focus on conservative treatment is all about getting the disc to heal with 8 weeks of STRICT rest (limited movement of the back).
-- The focus of conservative treatment is to get the disc to heal by providing a safe environment of the recovery suite.
    With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal.
    Those weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc.
    100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong disc scar tissue to form.
-- Limit risky-to-the-early-healing disc car transports.  Vets who know IVDD, take phone updates, adjust meds over the phone, etc.

Knowledge is key!
Owner understanding ensures proper conservative treatment principals:
    ▶︎ 4 phases of healing, what it takes to heal each phase: dodgerslist.com/healing-the-disc/
    ▶︎ 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

It appears as though Knox is on a typical path of nerve healing. After bladder control, next comes weak leg movement. Have you seen him attempt to reposition his body in the suite when lying down by trying to push/move the back legs at all? Maybe attempt to scratch an ear with back leg?  Any leg movement when he is dreaming?

With nerve healing the expectation is to think more in terms of months rather than days/weeks.  Nerve healing is the slowest department of the body to self repair.  Skin can begin healing in less than a week, bones in 6 weeks.  Disc in 8 weeks. 
Dr Isaacs, ACVIM (Neurology) says: "I also advise that at 2-4 weeks we are not seeing the end result of the healing process - this typically does not occur for 6-12 months and in some cases even longer."

Jenny, your Knox has done amazingly well in healing his nerves than what I had suspected before reading this new information.  As mentioned conservative treatment is focused on the disc healing in 8 weeks. But yet Knox is doing very welling the nerve healing department.  He is on a roll in nerve function repair!!!

Look for your self how further along the list of healing he has accomplished.:

4. YES!! Weak leg movement such as to reposition in the suite, and then
    YES!! Ability to move up into a stand position by himself, and then
    ___   Wobbly walking.
5. __     Being able to walk with more steadiness  and
   ___    no longer knuckles under the paw(s), properly places the paw.
6. ___   Ability to walk unassisted.

Not all vets can know every disease for every species (birds, dogs, cats, reptiles, farm animals, horses) they treat. Vets are pediatricians, surgeons, dermatologists, dentists in their daily work. Just think of your own doctor. He does not specialize in every disease and he only works with the human species.  He will often refer you to specialist if he does not feel comfortable in his knowledge of a disease you may have.

PREDNISONE
This steroid hormone (dexamethasone or prednisone) has one job to do during a disc episode. Get all of the painful swelling around the delicate spinal cord tissue resolved. Prednisone does not repair nerve function.  
   All vet's must guess how long to Rx prednisone. The usual is a 5-7 day course. One vet Rx'd for a rather short 3-day course up at the anti-inflammatory level. It is not until all days of the taper doses are complete AND pain meds are stopped that you and the vet have proof positive there is no more need of prednisone.  
   With no pain meds on board on final pred dose 11/22 and no pain nor any worsening of neuro functions, that was proof not to Rx prednisone by whichever vet (#2,#3, etc) did that.  

Now that you know how pred works, Vet #1 who Rx'd the 3-day course (5mgs 2x/day)  and the pain meds was on the right track of treatment.  Would he have Rx'd more pred 11/22 when there was no pain, no increased neuro diminishment?   Have to admit kinda lost keeping straight the many vets which is which. You will have to figure out if he's to be on Knox's IVDD health care team or if you need to find an IVDD knowledgeable vet:  dodgerslist.com/2020/05/10/find-ivdd-vet/

Why does Knox not have one single vet you work with?  There were too many cooks in the kitchen!

Now that you know not all vets can know IVDD, it is on you to become the pet savvy pet parent to speak up for Knox. Be able to recognize well intentioned but harmful advice and politely say "no thanks."
    -- Shortcut thru IVDD: dodgerslist.com/2020/06/26/time-and-ivdd/
    -- How to carry out STRICT rest with lots of tips to make the time go smoother: dodgerslist.com/2020/05/14/strict-rest-recovery-process/   

Prednisone is one drug (a hormone) that MUST be tapered off under supervision of a vet.  It is time now to taper it and with the final every other day dose to be off of it. Call a vet in the morning and get the taper instructions that end in every other day doses.

Your job is, now, to make sure Knox will have limited movement of the back. Anytime a vet wants to "see" Knox, it must be for a very urgent health issue. Car transports can ruin all the disc healing with the potential risk of too much movement. If a re-tear of the disc, back to square one of 8 weeks of disc healing.  The pain of the disc tear for Knox.  The pain of more vet bills, etc. for you.

When you can, bone up on IVDD so you can care for Knox now. And importantly live many happy years ahead with the disease he was born with.

Strategies for finding a local DVM IVDD vet: dodgerslist.com/2020/05/10/find-ivdd-vet/

Keep in touch....let us know in the morning what is Rx'd for tapering off of pred.