Donna's Rudy 5/12 conservative. Cushings; GRAD 7/7

Donna glad you have joined the forum! We would love to zero in on where you could use help.
    It is normal to feel overwhelmed. You maybe just learning your dog was born with IVDD. Maybe you are uncertain of the outcome. One the best things I hear from you is that he still has bladder control. That means with time would be likely he can self repair the nerves going to the back legs.
        🏵To calm your mind, I bet you'd like a realistic idea of how long it takes to heal. This is one of the most frequent questions asked. Here is the answer along with two tools to help you during your dog's recovery time: ==> dodgerslist.com/most-asked-disc-disease-ivdd-questions


Fill us in on some details so we know all about your dog's treatment:

QUESTIONS:
★1 Is there still currently any sign of pain?
        List ONLY the signs you observe in your reply
    There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing. Phone your vet and report any of observations asap to get meds adjusted.
⚙︎ shivering-trembling ⚙︎ yelping when picked up or moved
⚙︎ tight tense tummy ⚙︎ arched back, ears pinned back
⚙︎ restless, can't find a comfortable position
⚙︎ slow or reluctant to move in suite such as shift positions
⚙︎ not their normal perky interested in life selves
➕if a neck disc:
  ◻︎ head held high/ nose to the ground
  ◻︎ looks up with just eyes and does not move head and neck easily.
  ◻︎ not eating due to painful chewing or in too much overall pain
  ◻︎ holds front or back leg up flamingo style not wanting to bear weight

★2 __How much does your dog weigh? 
        -- What date did pred start on?
           How many mgs each dose?  
           How many times a day given
           What date does the pred taper start on?
        -- Please include the "all important" stomach protector. Use Pepcid AC with any anti-inflammatory med (steroid or NSAID). Follow vets who are proactive. Avoid red flag signs: Not eating, vomit, loose stool, bleeding ulcers, red or black blood in diarrhea.
The usual dose of Pepcid AC (famotidine) for dogs is 0.44mg per pound. ==> www.1800petmeds.com/Famotidine-prod11171.html
--Give 30 mins before the anti-inflammatory.
--Dose thereafter every 12 hours for the duration of the anti-inflammatory.
           thumb.ibb.co/mEGRuy/91x_Aj_s00z_L_SY355.jpg **

★3 List any red flag signs of stomach damage you are currently observing in your reply:
Not eating, vomit, loose stool, bleeding ulcers, red or black blood in diarrhea?

★4 What is your dog’s name? Your name is Donna? 
★5 Did you specifically get a diagnosis of IVDD, aka: a disc problem, a disc herniation, a bulging disc, slipped disc?
   -- Is the vet a general DVM? or
   -- a specialist surgeon (ACVIM neurology or ACVS ortho)?

★6 What was the date you saw the vet for conservative treatment?
      If your dog moves around too much, the disc cannot heal. With pain medications to mask pain, dogs will not be in pain and want to be more active. So it is up to you to restrict your dog’s activity for them.
       i.postimg.cc/3rLH7g7X/320still-healing-disc.jpg **
     STRICT rest means: 
    - no laps                    - no couches
   - no baths                  - no sleeping with you unless in back supportive crate
   - no chiro therapy       - no dragging or meandering at potty times.

POTTY TIMES for dogs who can still sniff and pee
      Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps.
      Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. 
      A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. 
      An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on!
      dodgerslist.com/wp-content/uploads/2020/04/Potty-leash-harness400-19kb.jpg **

★8 Describe what you observe currently about neuro functions of the back legs. Can your dog....
       -- wobbly walk?
       -- Move the legs at all such as to help reposition in his crate?
       -- Wag the tail when you specifically do some happy talk?

Donna, thank you so much for the additional info, details you provided help us so much to understand.  

Rudy has relatively mild symptoms of rear leg wobbliness vs. the wrong impression we got that his legs were paralyzed!!

 Continue to stick with STRICT rest for disc healing.  Self repair of the wobbly rear legs may or may not be healed in the short time it takes the disc to heal. Anytime out of the recovery suite is a danger to the healing disc.  Especially at potty time.  Let us know pretty much follow the how to do it in my above post.

POTTY TIME
-- Are you carrying him to and from the potty place?
-- Using a sling to keep the back aligned and butt from tipping over?
-- Limiting him to a very, very few minimal footsteps to take care of business?

Good to hear the vet provided you with a range to times to give gabapentin.  However, to be able to follow along we need to know how often are you actually dosing every 8 or every 12 hours?

Prednisolone will begin the taper on Fri 5/19. While the taper is to signal the body to resume making its own steroid hormone, during a disc episode it is the PERFECT window for you at home to quickly assess whether prednisone has fully completed its job.  More detail and ideas on using prednisolone during a disc episode for you be prepared: ==> dodgerslist.com/2020/04/18/steroids-vs-nsaids/
    Having pain meds on board during the taper of the Prednisone is counterproductive. The pain meds will hide signs of pain if they still exist. Pain meds will delay getting back up on the anti-inflammatory level of pred, IF, if there still would be painful swelling. Having pain meds on board is like wearing blinders.
    Let us know which your vet prefers when the pred taper starts so that you can get a true read if there is still painful inflammation going on
— the backing off of pain gabapentin on 5/19
— the full stop of gabapentin on 5/19

i.postimg.cc/LsxvB4pN/plan-b-SM.png

Let us know when you have the Pepcid AC 10 mgs 2x/day on board. Rudy does not need another problem of bleeding ulcers on top of all he is dealing with.

CALMERS
Got some ideas for you on the crate frustration. Hope this will help you out.  Let us know which you found useful for Rudy.

Consider some of these ideas:

-- Put a garment you have been wearing and have not washed in the recovery suite.

-- Thundershirt® to calm anxieties similar concept as swaddling an infant to calm. thundershirt.com/products/thundershirt-for-dogs

-- Teaching self-calming exercises can also help your dog to relax more. You can make something as simple as eye contact a very rewarding behavior that also acts as a way for your dog to “ask permission” when he wants something. Dogs are generally much calmer when they are focused and aware of how to act to get what they want.
    To achieve this, reward your dog with a high-value food treat the moment he looks at you. You can also say "yes" or use a clicker to mark the exact moment your dog looks at you. Then quickly follow up with a treat
     [NOTE: for crate resting dogs, shift your body a bit] Wait for your dog to look up at you once more., Say, “Yes,” before giving treat. After about ten repetitions, say, "All done," and put the treats away. Come back later and repeat the exercise until you notice that your dog is genuinely beginning to make eye contact automatically in anticipation of hearing "Yes" once more and receiving his reward.
    [NOTE: treats should be deducted from the normal daily kibble intake to prevent weight gain gain weight during crate rest. The size of the treat is irrelevant to dogs. ]
wholedogtraining.com/images/stories/Are_all_dogs_trainable.pdf

If the amount of meat protein in treats is increased by more than 10%, the balanced kibble formula may become unbalanced.

For example, if you feed a dog 1/3 cup (5 TBSP) kibble:
• 5 tablespoons = 15 teaspoons
• Meat treats limit: 1.5 to 2 teaspoons
• The math: 15 tsp x .10 = 1.5 tsp

-- Provide a lick mat in the recovery suite. Freeze with some soaked and mushed up kibble, a slight slather of canned dog food or other lo-cal smear, as a very tiny treat but one that will take a lot of time to consume. Use as long as your dog is not exceeding the requirement of little neck/back movement during the recovery rest period www.amazon.com/s?k=lick+mat+for+dogs&hvadid=78202818358910&hvbmt=be&hvdev=c&hvqmt=e&tag=mh0b-20&ref=pd_sl_3b30nygjvi_e

-- Make the recovery suite or even his stroller more cozy by draping a blanket over part of the top.
dodgerslist.com/wp-content/uploads/2020/05/blanketTOP150.jpg **

-- Using any oral calmer in combination with a Pheromone diffuser seems to work best.  It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives (ACE, alprazolam or traZODone). Of course always keep your vet in the loop on all things you give your dog.

Place a DAP pheromone diffusor at floor level where the recovery suite is:
--DOG Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/

Use diffusor with one oral calmer from below:
1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbac
2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine.
www.vetriscience.com/composure-soft-dogs-MD-LD.php

Good job getting the Pepcid on board. Our IVDD dogs have enough to deal with without adding stomach problems. It starts to work in about 30 minutes, so best to give it 30 minutes before the pred and then with the taper every 12 hours.

Carrying him to the potty place and helping him stabilize his back legs will go a long way in keeping him from moving too much.

Good luck on the taper, which I see is due to start tomorrow. I see that you are cutting back on the gabapentin now. By doing this, it will quickly become clear if there is still swelling in the spinal cord, which will manifest as pain. The use of pain meds during this time may mask the appearance of pain. Pain would mean more time on the full dose of pred is needed.

Donna, you ARE doing the single most important of care. Ensuring the back/neck does not move unnecessarily in order the disc will have a chance to form good secure scar tissue.
    Since Rudy can move his back legs on his own even if wobbly, the muscles are active and firing and keeping up circulation! No need to actively massage his legs with potential to cause too much movement to the back.  However, a gentle petting touch such as sliding your hands down his legs could be something Rudy might enjoy. Who wouldn't enjoy a loving touching hand give a nice pet on the legs and the head!  Of course, again only if Rudy does not become rambunctious but remains calm and relaxed in his stroller recovery suite.

Keep us posted on the taper and what you observe. Fingers cross there will be no signs of pain surfacing.
Is gabpentin to be full stopped, 5/19 as the pred taper begins today?

Donna, Graduation day is 7/7.  In general would be prudent to maintain home care where Rudy would not be subject to excessive movement due to potential new things occurring on a trip that might cause a set back to square one. With July's 7/7 graduation then it will be time to begin a slow and gradual reintroduction back to physical activity and family activity.   Would that fit your vacation plans?
    We always have the view to prevent any potential for setbacks in disc healing by sticking to STRICT rest til graduation day.  Then we will have lots of good ideas to share with you on how to introduce Rudy in a safe manner to get back to family activities.

The pred taper has been going on for 4 days now since 5/19. What date is the next gabapentin reduction? How many more days till you will be able to have quality proof if pred had actually fully resolved pain or pain still remains that must have pred back on board to work on?  Gabapentin on board blindfolds you to the truth about pain.  

Glad to hear the lick mat is something helping Rudy to relax and occupy his time.

Providing the detail of a date is always helpful to us, thanks for understanding!
"▼Gabapentin to only once daily this week [DATE?]."
Here is a good explanation for understanding the "why" behind the answer to your brace question as well as other products on this page: ==> dodgerslist.com/2020/02/24/devices-supplements/

Such good news that there is only minimal knuckling now, Donna! Excellent sign of nerve healing so early in crate rest. Yes, keep those steps to a very minimum, only a very few steps to do his business and then picked up and carried back to his crate. Keep up the good work!

The next step would be to continue tapering off the Prednisolone, keeping a close eye on Rudy to see if any sign of pain returns. Should any sign of pain return, you'll need to immediately notify the vet so Rudy can be returned to all original meds for a bit longer. Pain = pressure on spine = more time on all meds. Once Rudy can be completely weaned off of Prednisolone with no sign of pain returning, then all that will be needed is continued strict crate rest until graduation day of July 7th. It takes a full 8 weeks for a damaged disc to heal. Too much movement before the damaged disc heals and the disc could tear more, even rupture and Rudy could be back to square one or worse. So keep up what you're doing as you're definitely on the right path.

Here are some tips to help calm Rudy in the crate.  If these do not help, it may be necessary to have the vet prescribe a mild sedative.

To calm your dog in the crate, it would be a good idea to cover the top with a towel. That should mellow him/her. It also creates a den like feeling that dogs love.

Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price.

Place a DAP pheromone diffuser at floor level where the recovery suite is.

Dogs: Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/us/Products/ADAPTIL-Calm-Home-Diffuser with dog pheromones

Use a diffuser with one oral calmer from below:

1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed

2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine.

3) Bach's Rescue Remedy is a liquid 5-herb combo to help with relaxation (Star of Bethlehem – Orithogalum umbellatum, Rock Rose – Helianthemum, Cherry Plum – Prunus cerasifera, Impatiens – Impatiens gladulifera, Clematis – Clematis vitalba)

Be aware you might be inadvertently training for unwanted behavior. To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting. So anytime you see unwanted behavior ignore it, turn your back, leave the room if you have to. Preferable is to start teaching what you do want before there is too much practice in doing the unwanted behavior. Anytime your dog is sitting or lying down quietly, give a reward. Soon your dog will see they get rewards for four feet on the floor, quietly sitting, etc.

Consider some of these ideas:

-- Many members have found a pet stroller to solve the whining problem because the stroller can be wheeled from room to room as you go about your activities. Pet strollers, however, should only be used when you are directly supervising and only inside during conservative care. More details on strollers: www.dodgerslist.com/literature/strollers.htm

--Caster wheels can be added to a wire crate so the crate can be wheeled from one room to the next so your dog can stay with you.

-- Put a garment you have been wearing and have not washed in the crate.

-- Nan Arthur, CDBC, CPDT, KPACTP writes:

"According to the book, Stress in Dogs, by Martina Scholz & Clarissa von Reinhardt, the most well-behaved dogs get 17 or more hours of rest and sleep per day.

Teaching self-calming exercises can also help your dog to relax more. You can make something as simple as eye contact a very rewarding behavior that also acts as a way for your dog to “ask permission” when he wants something. When dogs have a focus and an understanding about how to behave to get what they want, they are much calmer overall. To do this, each time your dog looks at you, say, something like, “Yes!” or use a clicker to mark the second he looks at you, and then give your dog a high-value food reward. Wait for your dog to look up at you again, say, “Yes,” and reward again. Do this exercise 10 or so times and then say, “All done,” and put the treats away. Come back later and do it again until you can see that your dog is really starting to make automatic eye contact in hopes you will say, “Yes,” again and give him his reward. " [NOTE: treats should be subtracted from the normal daily kibble ration so as not to gain weight during crate rest.]

-- If your dog won’t get too excited seeing what’s happening outside, during the day try putting the crate on the coffee table or the dining room table so there will be a view out a window and a better perspective on what is going on in the house from on high.

-- Play classical music or one of the wildlife TV shows.

-- Fill a Kong with soft dog food and freeze. Put part of the dog's total daily dinner kibble in the Kong to lengthen time to consume dinner. Good low cal snacks are carrots, apples, or frozen green beans, licking a frozen low sodium broth ice cube. Good thick low salt/no fat chicken broth is full of cartilage-building proteins and amino acids. Freeze it up into cubes for easy access as you need it. Fun and keeps the body hydrated: place cubes in a bowl for licking.

If a dog is jumping up at the sides of the crate, you can lower the ceiling of the crate. Cut a piece of cardboard the size of the top of the crate, punch holes in the corners and tie the cardboard down into the crate to the level of the top of the dog's head when standing. Or cover the top of the crate with a blanket or towel, bringing the blanket/towel down to the level of the dog's eyes so when he/she jumps up, he won't be able to see anything. That may discourage him/her from jumping up.

dodgerslist.com/2020/05/14/strict-rest-recovery-process/

dodgerslist.com/2020/02/24/tips-to-help-with-recovery-suite/

Please continue to keep us updated. Healing prayers for Rudy.

This is an excellent update, off pain meds and coming to the end with the taper without pain.

As our dogs start feeling better, they often want to get back to their usual activities. They do not know that it is the limited movement that allows the disc to heal. We pet parents do know this. Keep up the good work of allowing only a very limited number of footsteps when pottying.

Have you had success in helping him keep calm with a diffuser along with an oral calmer? This has been very helpful to a number of our members, as Marjorie mentioned.

Donna, you are probably the best one to judge the safety of the RV park trip.. Are you both planning on going with Rudy?   Will Rudy be able to stay calm or would there be situations that would cause him too much movement of the early healing disc.  A retear/relapse of the healing disc would mean starting all over at square one.

Let us know what your thoughts are pros and cons for Rudy's disc as you may know the RV park and what is it like there.

Donna, sounds like you have very good priorties to keep Rudy's disc healing same as if he were at home. Such a trip is possible when there is attention to details to ensure continued disc healing. Hope your family has a very relaxing and pleasant vacation.

With your rolled up blankets or towels snug around Rudy's body in the secured crate, his back will have the needed protection from movement as the truck corners and comes to stops.

Donna fully off all meds and no pain surfacing means all of the inflamed tissue around the cord is really gone.

With disc healing for 8 weeks til graduation day 7/7, continue to allow only a very limited footsteps at potty time. As long as he is not rambunctious in his body movements, he is free to use the back legs to push to reposition his body in the suite.  A lot of dachsies love to burrow.  If you can distract him to cut it short, then do so. Really there is likely nothing you can do, though.

Glad the family had a nice camping trip!

Thank you for the reminder. I guess I’m getting as anxious as Rudy is to get out of the crate/stroller!! Today is 6 weeks, and we have 2 weeks left. Thank you for all of your much appreciated help!!

June 26:  Rudy’s nails are extremely long at this point. Is there some Safe way I can clip them? He hates it and I’m afraid he’ll squirm and hurt himself. TYIA

Hello. Well, tomorrow is Rudy’s graduation day. I wanted to update you on how he is doing. He can walk a few steps, then falls over. His Back legs, obviously, are weak. He does very well with going outside to do his business. I’m not sure where to start with carefully strengthening his legs to improve his walk. He does not seem to be in pain at all. TIA