Melanie & Penny
New Member
FEMALE - Beagle/corgie . heart,seizures
Posts: 19 
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Post by Melanie & Penny on Mar 18, 2023 20:14:30 GMT -7
Hello everyone - we’re back!
After several good years after her surgery in 2017 - as well as a few rounds of successful conservative treatment over the years, Ms. Pen is having her most serious episode yet.
She started conservative treatment on 3/16 - but has rapidly declined since then.
Age: 12 (we think - she’s a rescue.
Weight: 17 pounds
Meds:
Prednisone: 1 5mg tab at night and 1/2 a tablet in the morning for 7 more days. Then taper down for 28 days.
Methacarbomal: 1/4 tab (125 mg) every 8 hours
Gabapentin: Originally prescribed at 1.5 tabs (75 mg) every 8 hours - but we had to bump it up to 2 tabs (100mg) every 8 to control her pain.
Trazodone: we stopped this once her pain seemed controlled. 1/2 tab (25mg) every 8-12 hours.
Pepcid: 10mg x2 daily
[MED LIST/HISTORY- Moderator's Note. Please do not edit
17 lbs 12 y.o.
3/18 new: l.rear knuckling and wobbly walking
prednisone as of 3/16: 5mg/2.5mg 2x/day for 7 days, then TEST TAPER on 3/24
gabapentin 100mgs 3x/day
methocarbamol 125 mgs 3x/day
traZODone 25mg NOT GIVEN
Pepcid AC (famtodine) 10 mgs 2x/day]
☆ 2 Penny is a beagle / corgi mix (we think)
☆ 3 She was diagnosed with IVDD back in 2017 when she needed surgery for a disc in her neck (see our previous thread). She has been seen by both her vet and her neuro last week [3/16] as well as an ER doc - and all agree she is having a disc episode. Due to her age and the fact that she has seizures and a heart murmur - we do not want to subject her to another surgery.
☆ 4 What was the date you saw the vet and started 100% STRICT crate rest 24/7 for 8 weeks?
We saw her neuro on 3/16 and started crate rest and meds that day. She could walk when we started. Last night she [3/17] yipped once and started shaking in pain so we took her to the ER - where they gave her ✙Methadone and Trazodone (Which ironically made her completely hyper all night) Today, [3/18] she started wobbly walking - but is resting.
☆ 5 Is there still currently pain - her pain seems controlled for now. She occasionally has a short panting session every now and then.
☆ 6 She is wobbly walking (her rear legs are involved) - but with the assistance of a sling she walked backwards with little less effort and gave me some wags. She is knuckling under. Although she has had many disc episodes over the years - she has never lost the ability to use her legs previously.
☆ 7 She can squat and pee - however stool just seems to “fall out”. Note: I’m updating this to she squats to pee and transitioned into poop stance this morning.
☆ 8 Eating and drinking OK? She is eating and drinking like the champ that she is!
Giving Pepcid AC (famotidine) to suppress production of damaging stomach acids? We are giving her 10mg of Pepcid twice a day. The worst thing is that I just started a new full-time job a week and a half ago - but I can get home at lunchtime for her. My husband can take her to work with him for a while too.
I do want to mention that tramadol has helped her greatly in the past - but we cannot seem to get it prescribed for her these days due to the opioid epidemic.
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Melanie & Penny
New Member
FEMALE - Beagle/corgie . heart,seizures
Posts: 19
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Post by Melanie & Penny on Mar 19, 2023 8:17:42 GMT -7
I do want to mention that tramadol has helped her greatly in the past - but we cannot seem to get it prescribed for her these days due to the opioid epidemic.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 19, 2023 8:22:33 GMT -7
Melanie, sorry to hear Penny is having another disc episode. Was the methodone a shot? (Duration of effect is 4 to 6 hours) Normally it takes 3 different pain meds to get the swelling down over the course of 7-30 days up at an anti-inflammatory level prednisone dose. Gabapentin (never pain), methocarbamol (muscle spasm pain) and traMADol (a general analgesic). The most effective pain control is dosing pain meds every 8 hrs (3x/day) Confirm the prednisone Rx:-- Prednisone started 3/16. -- She is taking 7.5mgs daily for 11 days? -- The taper starts on Monday 3/27? Did the knuckling as well as the wobbly walking both begin Sat 3/18? Dates for each are helpful to sorting out the sequence of things. In other words is the knuckling an increase neuro diminishment to the already wobbly walking? Rest for a conservative dog is necessarily much more STRICT than for a post-op dog. Limited movement of the back is what allows the disc to heal. Too much movement could further damage the early healing disc. The disc could in turn impact the spinal cord causing diminishment of neuro function. i.postimg.cc/26dgyWcP/Cons-vs-surgert-chunk.jpg **Be very careful of transports. Secure the crate in your vehicle. Transport carefully using a crate padded out with rolled up towels on either side of the dog to prevent movement or jarring the spine when braking or turning corners. i.postimg.cc/N0YM7022/Crate-transport-vet-diagnosis-CHUNK.jpgTrazadone is an anxiety med, not a pain reliever. It is good to be at home when you first give (as you were) to know what effect it has. Prednisone is in her body to begin work getting the painful spinal cord swelling resolved in 7-30 days. Pred taper days do no work on swelling they serve a diffrerent purpose. The taper pred dose makes a perfect window to know if all swelling had been resolved.
Plealse keep us posted on her pain. IF the pain meds are correct, then pain is in control round the clock. IF not the case, phone the vet to get meds adjusted over the phone to avoid a risky transport into the clinic and all that entails.
Repair of nerve diminishment may or may not come in the short time of 8 weeks it takes to form secure scar tissue on the exterior of the disc. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 19, 2023 8:25:59 GMT -7
If you browse through posts on the Forum, you'll see that traMADol is still being prescribed. Not fair to leave Penny to suffer in pain when there is still more a vet could do. Press the issue if you are still observing pain surfacing.
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Melanie & Penny
New Member
FEMALE - Beagle/corgie . heart,seizures
Posts: 19
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Post by Melanie & Penny on Mar 19, 2023 10:28:23 GMT -7
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While going potty supported with a sling - she wags her tail when she first gets out of her crate (we carry her inside a travel crate to her patch - rather than picking her up). She is knuckling only on her left rear side - not the right. She heads right back into the crate when she’s done. Such a good girl.
methodone? YES a single shot.
Confirm the prednisone Rx:
-- Prednisone 7.5mgs daily: I was unclear on that. She is taking that dose age for 7 days.
-- Taper starts on this Friday March 24.
Knuckling as well as the wobbly walking both begin Sat 3/18? Yes - both at the same time.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 19, 2023 11:08:19 GMT -7
Melanie, a 7-day course of prednisone is not unusual. With painful swelling in the cord still evident on 3/18, it may or may not have had time to resolve by 3/24. So..... -- Be prepared to quickly and accurately identify painful swelling around the cord. 1) pain meds are normally stopped on date of pred taper (3/24). Pain meds on board when the taper starts prevents you from the true picture about pain. Pain meds are supposed to cover up pain. 2) Coordinate with your vet/neuro about the stop of pain meds on 3/24. 3) If you would see pain while on pain meds, approaching 3/24, then there is no need to taper. Instead alert your vet asap for another likely 7-day course. It is good to have a full handle on how prednisone works during a disc episode. Including having a plan B worked out ahead of time should you not be able to contact your vet at night or over weekends. Rule of thumb on prednisone taper pain = swelling = back to original anti-inflammatory pred dose,
+pain meds and Pepcid AC
no pain = go to conclusion of pred taper.
No pain meds, just Pepcid AC for duration of prednisone,
finish out the 8 weeks of crate rest for the disc to heal
GOOD READING FOR YOU: dodgerslist.com/2020/04/18/steroids-vs-nsaids/ |
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Melanie & Penny
New Member
FEMALE - Beagle/corgie . heart,seizures
Posts: 19
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Post by Melanie & Penny on Mar 28, 2023 7:21:41 GMT -7
I was wondering what works for folks when they have to leave their pup alone during crate rest. So far, my husband and I have taken turns babysitting her 24/7 - and he has been taking her to work in her travel crate during the day. As she feels better - she is getting very frustrated with being in her crate. Shortly, she will not be able to go to work with him due to her craziness and insistence.
For working pet parents - what is the safest way to crate your dog while out of the house?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 28, 2023 9:45:13 GMT -7
Melanie, well Penny's feeling better certainly is a good sign. But an issue as you well described. See if any of the these ideas would suit the situation, -- Could one of you come home during lunch for a potty break? -- Is there a trusted neighbor you could hire to do a potty break? -- There may be an option to board her for the day at your vet? Maybe you could hire one of the vet techs? -- Is there an option to stagger you and your husband's work days, giving an extra hour or so of at home coverage time? -- Test out the effects for Penny with using the anxiety med traZODone. You want to know how she reacts while you are at home in case mgs need to be adjusted up or down. -- Do you have an on-line camera to observe her while at work? CRATE Safety measures --- In anticipation she might one day be able to raise up on back legs to put front paws against side of crate or other rambuctious behavior. There are many tips at Dodgerslist page on STRICT REST PROCCESS we recommend everyone read: Here is one of those tips from the section on "CALMERS • MUSIC • NO JUMP:: 1) Drape blanket down to head height of standing on all four legs dog. This way he can’t see if he jumps or stands on hind legs. Many dogs are calmed with a more den-like environment. Draping the blanket simulates that coziness. Now that PREDNISONE is in the taper since 3/24, how are pain meds being handled: full stopped or back down for you to best observe for pain and or any new or increased neuro diminishment? Last you posted 3/19 she was only knuckling under on left rear side
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Melanie & Penny
New Member
FEMALE - Beagle/corgie . heart,seizures
Posts: 19
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Post by Melanie & Penny on Apr 2, 2023 8:18:58 GMT -7
We’ve done many, many strict crate rest periods in the past - so we’ve got recovery crates covered with blankets and set up already (many thanks to this site!). Thanks for all the tips and tools.
Penny Pupdate: She is walking much better now - no knuckling - but is still somewhat wobbly at time and needs some sling support. She is not in any pain - and Trazodone has been helping keep her quiet (for the most part). Oddly, long-term use of Pepcid actually upsets her stomach (which we discovered the last time when she was on crate rest before this). We cut it back her ▼Pepcid from twice a day to once a day (just before she gets her 1x a day Prednisone dose) - and now her stool is back to normal.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
17 lbs 12 y.o.
3/18 new: l.rear knuckling and wobbly walking
4/2: no longer knuckles, slightly wobby
prednisone as of 3/16: 5mg/2.5mg 2x/day for 7 days, then TEST TAPER on 3/24 for 28 days; final taper dose on 4/21
gabapentin 100mgs 3x/day
methocarbamol 125 mgs 3x/day
traZODone 25mg
Pepcid AC (famtodine) 10 mgs ▼1x/day -history of famotidine upset]
We’re planning on getting a x-pen for her with a nylon bottom and top for additional support. We hope to be able to put her travel crate in there alongside some pee pads for when we’re not home. I don’t trust boarding her yet - even we don’t pick her up or handle her at all at home (except to reach into her crate and giver her pets). She is only out of her crate when she goes potty - and she does that under her own power. I don’t want anyone picking her up incorrectly - not even us.
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Post by Ann Brittain on Apr 2, 2023 8:32:26 GMT -7
I'm glad Penny is making such good progress. Crate rest is key to recovery, as you know. It's great that you're thinking about ways to keep Penny's activity level restricted until she's fully recovered. Keep us posted on her progress.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 2, 2023 13:06:01 GMT -7
Melanie, nerves already healing---no knuckling during the pred taper sounds very good. Have the pain meds (gabapentin and methocarbamol) been stopped to allow you to quickly and assess for pain during the pred taper?
When you get the ex-pen set up, if you are able, share a picture and tell us about it. Might be helpful for others in a similar situation.
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Melanie & Penny
New Member
FEMALE - Beagle/corgie . heart,seizures
Posts: 19
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Post by Melanie & Penny on May 7, 2023 8:04:27 GMT -7
Hi all!
We’re in the last week of crate rest! Whew!
We have started leaving Penny in a large x-pen suite during the day while we’re at work. Inside the x-pen is a “recovery crate” and a spot in front of the recovery crate for her bowls and some pee pads. We blocked off excess space by attaching the open door of the recovery crate to the side of the x-pen with zip ties. The x-pen we bought has nylon floor and roof coverings which make it more stable, but also keep her from wanting to stand on her hind legs. It’s working out great! We have a dog cam and check in on her while we’re at work and she spends her day primarily snoozing.
After her initial improvement, her mobility has remained much the same. She can walk on her own (quickly too) - but will wobble and loose her balance in the rear every once in a while. There’s a video of her in my Instagram @ melanie.coffee . She still seems pain free. She has gained some weight - but I’m hoping she’ll lose it once we stop her steroids and Trazodone. We have a follow up with her neuro on the 12th.
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Post by Ann Brittain on May 7, 2023 8:40:51 GMT -7
Great news about Penny's recovery. As you know, it takes time for nerves to heal and it will take time for her to regain her strength after weeks in a crate. It is important to keep her weight under control. Excess weight will put more stress on her back which is something you want to avoid. If she's not already on a low-fat diet you might want to ask your vet to recommend one. Also as she gets stronger and more active it will help get her back in shape. But be careful not to let her become to active too soon.
Keep us posted on her progress.
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