Jean’s Mimi 3/12 conservative; GRAD 5/7

Hi Jean, oh dear,  I'm sorry to hear Mimi has had another disc episode.

The great thing is you knew to crate at once on 3/12 and get to a vet to prevent further damage to the spinal cord and the disc.

Did Mimi see an ER vet on Sunday 3/12 or her regular vet?
What date did the carprofen start?

Some things to consider
    · Pepcid AC lasts for about 12 hours.  That is the reason to dose it every 12 hours. Is there an issue with dosing that often?
    · It is always a worry for us to see them with leg weakness, for sure.  Do keep in mind the usual progression of nerve diminishment. You can see there is still good hope. Good hope that Mimi will likley self repair the leg nerve damage.

MONITORING 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
l   √  legs cross
3. √ R&R rear Paws knuckle under.
    √ slow to correct or can't right the paw(s) at all?
5. ? Weak/little leg movement such as to reposition in crate?
    ? 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/

Do let us know the details of the back legs:
  Can she move up into a stand?
  Can she right her back paws even if slowly. Or can't at all?

That is good the vet did give you a range to use the meds. So we can follow along do tell us what you actually are given now and how long a course of Carprofen.
    carprofen start date?: 12.5mgs 2x/day for ? days, then a test STOP for: _pain?/_neuro?
    gabapentin 50mgs ?x/day actually given?
    traMADol 25mgs 25mgs ?x/day actually given?
Just a reminder there is alway an option to use an aggressive pain med approach if what you give now does not provide dose to dose full management of pain.
    -- Pain meds last for about 8 hrs. An aggressive dose is 3x/day dosing
    -- There are normally 3 sources of pain. Thus vets typically provide pain management for all 3 sources:
     traMADol as the over all analgesic. 
     gabapentin for nerve pain
     methocarbamol for muscle contraction pain.

I'm so sorry to hear that Mimi is having yet another disc episode, Jean. Do try to stay positive. And do try to use a happy voice around Mimi. They easily pick up on our moods. Tell her every day that she's getting better and you believe it, too!

It's good that she still has deep pain sensation and some movement. With the worsening of her condition while on conservative care, did the vet discuss the possibility of surgery with you when you met today? We have seen many older dogs do very well with surgery. Or is surgery not an option?

When the Carprofen is stopped, the pain meds should be stopped, too. You may remember that from Mimi's other disc episodes. Having pain meds on board once the anti-inflammatory has stopped will mask any pain that you need to see to determine if there is still swelling pressing on the nerves of the spine. Do speak to the vet about stopping the pain meds when Carprofesn is stopped. Should you see any sign of pain at that point, then you would need to immediately advise the vet so the meds can be restarted for a bit longer.

I do know how scary this can be. Try to take it one day at a time. We've seen many, many dogs with complete paralysis recover with conservative care and Mimi is not paralyzed. She has some movement. You may or may not see that recover occur during the 8 weeks of conservative care, it may take a bit longer. Hang in there. We're here for you and Mimi. Healing prayers for Mimi.

Jean, do let us know the details on med adjustments. Vet has many options to adjust meds not yet taken.

Excellent she retains bladder control, meaning her neuro functions have not declined. Getting pain fully in control, allows her to continue with crate rest in comfort.

Do you have a pet stroller? A lot of dogs enjoy being up higher to see around their home. Also you can keep her by your side as you move about the house or relax on the couch/recliner.

Do you have someone to care for her (potty times) while you are out at work?

At night you could put her crate on a sturdy table beside your bed. That was she can see and smell you, you can put your fingers through the wires to comfort her.

Jean, fingers  crossed the med adjustments provide night and day freedom from pain.
   traMADol just in case to discuss with vet.   This med could be used at the max analgesic for 13.6lbs (6 kg) Mimi:  
                 6kg Mimi x 10mgs traMADol = 60mgs dose 3x/day

Hope to hear the traZODone helps with anxiety. Maybe if she has full pain control, she will be able to relax in her suite?  

The day carprofen stops is an important day.  We'd like to be prepared to follow along. And to know if the pain meds will also be stopped the day carprofen stops?  More on how anti-inflammatory drugs are used during a disc episode:  dodgerslist.com/2020/05/14/strict-rest-recovery-process/
   What date did carprofen start? 
   For how many days is she to use?

Oh, Jean. I am so very sorry for your loss.