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Post by Brittany & Oakely on Dec 27, 2023 23:45:22 GMT -7
Hello! My name is Brittany I have a 4yr old Doxie (DOB 12/17/19) named Oakley who weighs 21lbs. We are located in the US. On December 7th out of nowhere our dog yelped out- standing still on flat carpet. He seemed fine walking normal and went on like nothing happened. The next morning his sides/abdomen were really tight and he yelped out when we would touch him. We honestly thought maybe constipation. Gave him some pumpkin puree and monitored him over the weekend. Sunday night he wouldn’t come up the stairs. Monday morning (12/11th) we took him to the vet and they diagnosed a pulled muscle. Started us on prednisone 5 [mgs?] every 12 hours, methocarbamol 250mg every 8hrs. He was better by the next day and back to normal. We continued meds but we were never told crate rest since he was misdiagnosed. Fast forward to 12/14 [relapsed disc] and same episode- helped out, tight sides but this time much weaker on his back end. In a lot of pain again despite meds.12/15 back to the vet and still claimed pulled muscle and added gabapentin 100mg every 12hrs. I started my own research and suspected IVDD so I started crate rest 12/15.He was doing okay but was getting very wobbly when going potty. I decided to get a second opinion from a holistic vet. We had an appointment with them 12/20 and they feel sure it is IVDD stage 2. We did acupuncture that day and b12 injections. Oakley was not in pain any longer so they had us cut the methocarbamol to 125mg every 8 hours and start weaning prednisone on the 22nd to 1 tablet a day (this made 1.5 weeks on full dose) He actually seemed to feel a little better in the coming days and had some more mobility. We called for a refill of gabapentin and they said to just stop once our since he was doing well. We stopped gabapentin 12/23.12/25 he was in excruciating pain. Tight sides, couldn’t be picked up to potty, not walking at all, legs tucked under himself. Of course both our vets were closed and the emergency vet wouldn’t refill our gabapentin without an exam which we felt would stress him and hurt him further. I was able to get the same dose 100mg from my dad and gave that to him that evening and the next morning until our vet reopened. They called in more gabapentin and methocarbamol but want us to continue on only 1/4 tab of the methocarbamol. They also started us on a Chinese medicine supplement for hindquarter weakness.So as of today [12/28] he is taking 100mg gabapentin every 12hrs. 125mg methocarbamol every 8 hours. 5mg prednisone every 24hrs, and the supplement twice a day. [MED LIST/HISTORY- Moderator's Note. Please do not edit
21lbs 4y.o.
12/15 crate rested
prednisone as of 12/15 relapse: 5mg 2x/day for 7 days; 12/22 taper for: √12/24 pain; √12/25 weak legs_ neuro
gabapentin 100mgs 2x/day
methocarbamol 125mgs 3x/day
Jing Tang Hindquarter Weakness.
Pepcid AC ?mg ?x/day for duration of prednisone ] He’s resting well but still seems in pain when going potty. Yelps when you pick him up, doesn’t take steps unless assisted and you help put his legs under him. Is having trouble pooping because he’s so weak. He will fall down into his poo. We’ve tried using a sling however he won’t pee at all if we use it and he yelps because it’s touching his very tight sides.We are nearby Virginia Tech vet school but their neurologist will only see him if we get an MRI but it is $3000 alone and that’s a lot for us. Hence why we are trying this conservative route. I just feel like maybe the neurologist could help with advice and meds better than the general vets we are under currently. My main concern now is pain, I can’t let my baby suffer and I’m not ready to give up on him. Should I give the meds more time to be effective again, call the vet for more meds or increased dose? After reading everything what are your thoughts? I did read since he’s on prednisone he needs Pepcid AC so we are starting that now (I know we’re late but hopefully it helps some). He shows no red signs of GI issues. He’s eating/drinking great, nice normal bowel movements. Also he has 9 days left of prednisone and we don’t have any direction on weaning anymore just taking 1 a day until gone- does this sound right? I worry he was doing better because he wasn’t in pain. Now it appears he’s in so much pain he’s afraid to move. He does still have mobility if you assist and he has a happy wagging tail. |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Dec 28, 2023 9:19:35 GMT -7
Brittany, I'm so sorry to hear of Oakely not getting the treatment needed. There is still very good hope. Once you know the correct treatment you can advocate with a same vet or get a new higher educated vet about IVDD. You don't need a neuro at this point. If you can get in to see a Virginia Tech vet, they may well have seen more IVDD than your locals. PREDNISONE The key drug is prednisone. It takes from 7-30 days to get the swelling gone. Unfortunatey with no crate rest until you researched and guessed this could be IVDD, all prednsione before you started rest on 12/15 was for naught! -- Upon crating with the relapse to the disc, Oakley has only been on prednisone for 7 days. -- The pred taper is to test to see if any more prednsone is needed. -- Chinese medicine does not have the power of prednisone and may not be compatible with prednisone. What is the name of the Chinese medication?ADVOCATE today! You do have an emergency to get pain in control and pred back on board to work on swelling around the cord.-- It is best if you do not need to further transport Oakely with potential for too much movement to the healing disc. If you have to take him to a new vet to get the right meds, then so be it, you have an emergency. --- Advocate for another 7-day or 14-day course of Prednisone 5mgs 2x/day.--- Advocate for all three pain meds to be on board at an aggressive dose. Pain meds last for 8 hrs. Thus the reason to be Rx'd 3x/day (every 8 hrs).
--- NOTE with severe pain, the vet may need to give a pain med injection, just to help get pain back in control. Then the pain meds for you to give at home. The best pain medications control is using more than one approach to address pain from multiple fronts (traMADol-general analgesic, methocarbamol- muscle spasm pain, gabapentin-nerve pain). All three pain meds need to be prescribed three times a day (every 8 hrs).
Amantadine: for hard to control pain. Discuss with the vet pills for at home. Click the link because this is not a pain med per se to learn its mysteries. Neuros are using to help with tricky pain Amantadine
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. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock.
SIGNS OF PAIN: ⚙︎ shivering-trembling ⚙︎ yelping when picked up or moved ⚙︎ tight tense tummy ⚙︎ arched back, ears pinned bac ⚙︎ 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
-- Learn about Prednisone. An informed owner is a dog's best defense when taking an anti-inflammatory. What your job is, how to arrange for a Plan B with your vet.
 **
Weigh the risks vs. benefits Vets who know IVDD will often take phone updates, adjust meds over the phone to allow the safer option of crating at home for the healing the disc. A benefit for a most urgent of a vet visit for a health reason such as, out of control pain, new neuro loss, learning to express, urinalysis etc., outweighs an exposure risk to an early healing disc of too much spine movement. 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.
Please keep us posted when you can. |
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Post by Brittany & Oakely on Dec 28, 2023 14:34:01 GMT -7
Thank you so much for the reply. I believe you are correct on Tech possibly knowing more on IVDD and better controlling the pain. The Chinese medicine is Jing Tang Hindquarter Weakness. The holistic vet did say it was okay to take with the prednisone. Please let me know if this in incorrect. We have a new issue now. He’s pooping in his crate. We are taking him out every 3-4 hours. He will poop outside on his own as well. Is he just not fully emptying? It doesn’t seem like he’s lost control of his bowels because he will go outside like normal. Last question- he’s had a fever each time we’ve taken him in. Is this because of pain, and anxiety of the vet or could this still be something else? Meningitis and lymes came up with similar side effects including fever. It was 103.7 the last time. 102.5-103.5 at home. The vet didn’t mention a fever at all. I happened to see it on our exam sheet when we returned home. Our holistic vet is not on board with tramadol or increasing meds so we are going to Virginia Tech for an emergency visit [date? 12/28??]. I wanted to add to my last response. Is acupuncture warranted this early? Could that have added to his set back? So many things were changed all together and so quickly I’m not sure what caused the set back in pain. It was controlled at one point and we had a happy perky boy. Would laser therapy be a better option or just staying home on crate rest until 2/5? Sorry for all of the questions. I appreciate your help and time!! |
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Post by Romy & Frankie on Dec 28, 2023 15:11:30 GMT -7
Is Oakley now back on the full 2x/daily dose of pred? Has there been a change in pain meds? Is his pain now under control?
IVDD does not cause fever, so there may be something else going on. In any case, although Oakley's temperature was elevated, the vet must not have thought it was high enough to cause concern.
IVDD does sometimes cause weakness in the sphincter muscles, which could result in pooping in the crate. Oakley still has some bowel control as he does poop outside, but his bowel control may not be complete.
There can be possible negative reactions between any prescription med and Chinese herbs. Chinese herbal medicines are composed of many herbs in one bottle/pill. To familiarize yourself on what your dog is taking, and any possible side effects, you may need to look up each herb separately. |
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Post by Brittany & Oakely on Dec 28, 2023 15:29:51 GMT -7
Romy & Frankie- no he is not back on the full prednisone 2x a day. He’s been on 1x a day since 12/22. The vet wanted to start weaning at that day. He was not in pain at that point. Methocarbamol was reduced to 125mg 3x a day and gabapentin was stopped 12/23. His pain returned 12/24 and hasn’t been under control since. The vet added back gabapentin but the other meds are the same.
Current regimen
Prednisone 5mg 1x a day
Methocarbamol 125mg 3x a day
Gabapentin 100mg 2x a day
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Post by Romy & Frankie on Dec 28, 2023 16:09:00 GMT -7
During a taper, when pain is seen, we know there is still inflammation of the spinal cord. The full dose of pred 2x/daily is what will work on this. We know that Oakley started the taper on Dec 22 and his pain returned on Dec 24. This indicates more time on the full dose of pred is needed.
Please advocate for a return to the full dose of pred and an adjustment to pain meds. Oakley should not be in pain. Gabapentin does not last long in the body and may need to be prescribed 3x/daily for full relief. The vet may want to add tramadol to his medication mix if his pain is not controlled by 3x/daily gabapentin.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Dec 28, 2023 18:26:23 GMT -7
Brittany, thank you for the update. Let us know what the Virginia Tech vet Rx's.
I looked up each ingredient in the Chinese Jing Tang. I did not see conflicting ingredients.
A dog's normal body temperature ranges from 101° to 102.5° Fahrenheit. The stress your dog was under going to vet, in pain could have raise the temperature a tiny bit. When Oakely is relaxed and comfortable at home, some day take his temperature so you know what HIS normal temperature is.
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Post by Brittany & Oakely on Dec 29, 2023 23:54:26 GMT -7
I just wanted to give an update. We were seen by neurology [date?] and given the option to continue conservative treatment with increased meds or have an MRI and surgery tomorrow. Financially surgery isn’t an option so we are really hoping the med adjustment gets Oakley out of pain.
The Rx is: Prednisone 5mg 2x a day [for how many days?], ▲gabapentin 100mg 3x a day, methocarbamol 250mg 3x a day. The holistic vet added ✙hypericum [St. Johns Wort] as well.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
21lbs 4y.o.
12/15 crate rested
prednisone as of 12/15 relapse: 5mg 2x/day for 7 days; 12/22 taper for: √12/24 pain; √12/25 weak legs neuro
VT Rx as of 12/29: 5mgs 2x/day for 7 days, 1/5 test taper for: _ pain; _ neuro
gabapentin 100mgs ▲3x/day
methocarbamol 125mgs 3x/day
JingTang Doks Formula as of 12/29
✙hypericum [St. Johns Wort]
Pepcid AC 10mg 2x/day for duration of prednisone ]
We were given statistic of 50-60% chance of recovery with conservative treatment and 90% chance with surgery. I wish we had the means to opt for surgery and put this behind us but as long as Oakley isn’t in pain Im happy to continue strict crate rest. The vet didn’t see the need for famotidine as I’ve read on here so I was wondering if anyone could help with dosing. 21lbs and I have 20mg tablets I ordered from Amazon.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Dec 30, 2023 10:08:10 GMT -7
Brittany, if for whatever reason there might be that a surgery is not an option (health issue, financial, etc.), then be assured if surgery is not an option then the best option is conservative therapy. Dogs are not privy to the statistic percentages. So often their bodies just go about the business of healing and owner's seeing with time a "miracle" of getting back to family life and having fun. You have the right attitude to keep Oakely's spirits up. Fingers crossed Oakely is finally on the right track with another course of prednisone and pain meds to aid in his recovery. What date did you go Virginia Tech?
What kind of a vet did you see there? A DVM vet? Or a DVM, ACVIM (Neurology) vet? It makes a difference when you report to know what level vet you saw. What did the vet you saw say about Oakely's temperature in the past days and the day you saw the VT vet? For how many days is Prednisone 5mgs 2x/day to be given? As of today how is Oakely's pain? Is pain fully covered now day and night, dose to dose of gabapentin and methocarbamol every 8 hrs (3x/day)? If pain is not fully covered, call in feedback about pain to VT and advocate for synthetic opiate traMADol and possibly Amantadine. Note traMADol is not compatible with herb St. Johns Wort (hypericum). Did you learn the reason for hypericum? What do you observe currently about his back legs? -- still can do a happy tail wag? -- can still move rear legs in walking motion when supported by a sling. -- other____?Pepcid AC (famotidine) 21 lbs dog X 0.44mgs famotidine= 9.24mgs
Round up to a 10mg dose and give every 12 hrs (2x/day)
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Post by Brittany & Oakely on Dec 30, 2023 12:05:24 GMT -7
Hi Paula, we were seen at Virginia Tech 12/29 by a DVM. They performed a neuro exam and communicated with the on call neurologist their findings. The neurolocalization was t3-l3 myelopathy with the cause likely being IVDD disc herniation. No MRI was done to confirm this.
His temperature was 103.3 12/29 at Virginia Tech. The vet didn’t mention this and the vet tech said it can raise due to pain and stress of the vet but he was calm when we went in. I will be calling back today to get clarification if these fevers should be of concern of something else going on. I will also check his temperature at his next potty break.
He gave us enough [prednisone] for a week to see how he improves and then said to call back or contact our regular vet for more medication.
He seems to be resting well today. I am noticing he will shiver every now and then.
The reason for hypericum is for pain because the holistic vet wasn’t on board to increase any meds or give more prednisone. They discontinued hindquarter weakness and added ✙JingTang Doks Formula. I’m on the fence at this point with the holistic/Chinese medicine stuff. I don’t know if it’s worth continuing. We have an appointment 1/2 for acupuncture and laser but we are choosing to keep him on crate rest instead of going out for that kind of appointment so soon.
He does still have a happy wagging tail. He doesn’t move his back legs when lifted off the ground. He drags them knuckle down if not supported. After the neuro exam at VT they said he does still have motor function of his back legs but is incredibly weak.
Thank you for the dosing on famotidine
I also want to add that the DVM at VT said since he wasn’t treated properly with steroids and diagnosed correctly right off that we have a chance of spinal cord necrosis from the inflammation and disc. That this is fatal and even surgery couldn’t stop it. Is this common?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Dec 30, 2023 22:41:22 GMT -7
Brittany, since Oakley is now seeing a VT DVM because you do not have any local IVDD knowledgeable vets, you will be able to call in updates, get med changes over the phone should it be needed. As always seriously weigh the benefit of a vet visit over the potential risk of too much movement damaging the healing disc. Vets who know IVDD, understand essential crate rest and will handle what is possible over the phone. VT DVM gave Oakely a 7-day course of Pred. The taper date will be on Friday 1/5. The best assessment if pred had completed its job, is to also have pain med gabapentin, methocarbamol to also stop on 1/5. If you've not already stopped the holisitic stuff, definateley do it on 1/5. Did VT know about the herbs your holistic vet has Oakely on?CHINESE MEDS Chinese Herbs are composed of many herbs in one bottle/pill, meaning you will need to Google each one to familiarize yourself on what your dog is taking. There can be possible negative reactions between prescription meds and Chinese herbs. Very experienced holistic vets will be hesitant to prescribe Chinese herbs when conventional medications are already in use. The reason is there is no sureness there would not be any interactions with the other medications that could make your dog sick or worse. Did you look up these herbs? hypericum [St. Johns Wort] is used for depression. Jing Tang Doks Formula: Bai Ji Tian, Bu Gu Zhi, Chuan Niu Xi, Chuan Xiong, Dang Gui, Du Huo, Du Zhong, Gan Cao, Bu Sui Bu, Rou Dou Kou, Rou Gui, Wu Yao, Xiao Hui Xiang, Xu Duan, Ze Xie, Qiang Huo Overdoses can cause gastrointestinal discomfort, including nausea and vomiting
Confirm, please: •Are you now giving Pepcid AC at 10mgs 2x/day?
•Prednisone started on 12/29. 5mgs 2x/day for 7 days, then 1/5 taper
Current Neuro Functions Since he CAN do a happy tail wag, has bladder control, weak rear leg movement, by definition he must first have deep pain sensation (DPS) to do those things. So not only currently having DPS but also other neuro functions gives good hope for leg nerves to heal over time. The VT DVM is referring to myelomalacia. Not all vets have seen "M" because it is not so common. Loss of deep pain sensation (DPS) or leg function not returning right away alone are not a symptoms of "M". The cause of "M" or why it progresses is still unknown. More on Myelomalacia: More information: dodgerslist.com/2020/05/08/myelomalacia/MONITORING NEURO FUNCTIONS As damage to the spinal cord increases, there can be a predictable stepwise deterioration of functions due to excessive back/neck movement for example. 1. 12/11 + relapse 12/14 Pain with initial disc tear & ensuing swelling 2. __ Wobbly walking __ legs cross 3.__ Nails/toes scuffing floor 4. __Rear Paws knuckle under. Dog is slow to correct or can't right the paw(s)at all 5. 12/29 Weak/little back leg movement 12/29 can't move up into a stand with back legs 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 (DPS), the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If DPS would be lost, it can come back as nerve healing begins its slow repair process. |
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Post by Brittany & Oakely on Dec 31, 2023 5:12:23 GMT -7
Do you feel a week of prednisone 5mg 2x a day is sufficient before tapering again? I worry because when we did this 12/22 (a week of prednisone 5mg 2x a day and stopped gabapentin) Oakley became in extreme pain that we couldn’t get under control. I know he can’t be on prednisone long term I just wasn’t sure if a week is enough time to bring the swelling down. Our original prescription was for 2 weeks 2x a day, 2 weeks 1x a day, then every other day until finished. I just don’t want things to get out of control again.
The VT vet was aware of the Hypericum and Doks Formula but admitted he did not have enough training in those types of treatment to give us any advice on using them.
I did look them up and found Hypericum is also used for nerve pain, specifically back nerve pain. We notice he is more relaxed and comfortable after giving hypericum but we see no difference when giving Doks Formula. Doks Formula is used for chronic pain of arthritis and degenerative disc disease. We can discontinue Doks formula today 12/31.
Yes we are giving Pepcid AC 10mg 2x daily.
Thank you for the myelomalacia link!
When he goes potty outside if he takes a few steps [with front legs] he can’t get his back legs under himself and drags them with his knuckles down. When using a sling he gets very excited to take a few steps and wags his tail. It seems like instant relief to him.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Dec 31, 2023 10:32:10 GMT -7
Brittany, it is lovely to hear Oakley's spirit is such as he can give you a happy wag. Those are so lovely to see! It is quite possible for nerves to heal where Oakley no longer knuckles his rear paws. Think more in terms of months rather than days/weeks for the slowest part of the body to heal....nerve functions.  ** Unfortunately no one would be able to tell you how long to use prednisone. • All vets must take a guess as to how long the course should be. • The important part of prednisone is the part before tapering. For Oakley that is the anti-inflammatory level: pred 5mgs 2x/day. • Taper doses no longer work effectively for swelling. The taper which ends in an every other day dose is to signal the body to make its own cortisol steroid hormone again. • It may take prednisone anywhere in the neighborhood of 7 to 30 days at the anti-inflammatory level course. Todate, Oakley has been Rx'd two 7-day courses (14 days) of prednisone. When the steroid tapers on Jan 5th, this will be a test of sorts to see if another pred course is needed or not. My fingers are crossed that 14 days of pred will do the trick. • There would be no need to even do the taper should any pain surface nearing dose time as 1/5 approaches. 'Cause then you know pred needs more time, another 7-day or could be a 14-day course as the vet feels is best. •When and if the taper does take place, that will be the true test to find out about swelling around the cord. It is usual for things blocking pain (hypericum, gabapentin and methocarbamol) to be stopped. In some few cases a vet may call for backing down of methocarbamol, gabapentin. Please let us know what your vet wants for Oakley when the taper starts on 1/5: full stop on pain meds or backing down. Any hint of pain on the taper when vet is closed, you want to be able to bring him back into comfort zone asap with pills available til your vet re-opens to update him.
With any TAPER, it is always good to have worked out in advance a "PLAN B" should pain re-surface at night or on the weekend when your vet is not open. Could be an emergency RX script you could fill at local 24 hr pharmacy or some extra pills on hand (pred back up at anti-inflammatory level + methocarbamol and gabapentin back on board) at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free!
RULE OF THUMB during a taper Pain= another course of PRED
+ all pain meds, GI protectors back on board. No Pain= go to TAPER conclusion
...finish out the 8 weeks of crate rest for the disc to heal. |
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Post by Brittany & Oakely on Dec 31, 2023 21:22:53 GMT -7
Thank you so much!! This is all so very helpful!
To add to Oakleys current condition he is now passing bowel movements in the crate and doesn’t seem aware he’s doing this. He’s no longer pooping outside at all. He is still peeing outside but is occasionally peeing in the crate too
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Jan 1, 2024 10:01:35 GMT -7
Brittany, describe the release of urine outdoors. After you set him down on an old pee spot. What does he do? --- Does he sniff and then you see a release of urine. That is the sign to verify the brain is sending a message to the bladder to release urine. It show he still has bladder control --- Make sure the sling is not pressing on the belly area/bladder as that could cause a reflex reaction to release urine. You could support him up by his thighs if you don't have a figure 8 sling. A dog with bladder control "pees" when his brain directs opening of the sphincter muscle to release urine. Normally a dog would have to be in an appropriate place such as outdoors, wanting to mark a spot with his urine, etc. Head level involvement is a requirement for us to know if the brain is directing. So sniff (head level) then you see a release of urine proves bladder control A dog with no bladder control "overflows" when enough pressure has built up in the bladder to cause reflexes to open the sphincter. The bladder will overflow anywhere, often in an inappropriate place (bedding, floor, etc.) If it is determined that Oakley is "overflowing," then for health reasons to protect the kidney, UTI developing, you will need to get a hands on top of your hands type of "Expressing the Bladder" lesson from vet or his vet tech today. You can get an idea of expressing the bladder at this link. Which will give you a heads up before you get your lesson and tips, too. ==> dodgerslist.com/2020/05/05/bladder-bowel-care/Have you tried expressing for poop? Expressing for poop is so that before mother nature would just let it plop out anywhere, you get there first to encourage poop to clear from the digestive tube to plop out where you desire. You really do not need anyone to demonstrate how to express for poop. Helpful poop expressing tips: dodgerslist.com/2020/05/05/bladder-bowel-care/#poop
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Post by Brittany & Oakely on Jan 1, 2024 12:29:24 GMT -7
He does sniff and pee on his own. We’ve been holding his thighs for support because he won’t pee with a sling on. We don’t have a figure 8 one. I think he just needs to go more often because of the prednisone. So far today 1/1 he hasn’t peed in the crate at all. He has pooped in it once. After taking him outside- when carrying him back in he has pooped twice now. In mid air when carrying. He doesn’t seem aware of doing it at all. I will try the expressing technique next potty break.
I also called VT back and the DVM that saw him for ER 12/29 wants▲prednisone to continue for 2x a day for 2 weeks [14 day course] before tapering. He wants to see a return in some neuro function before tapering.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
21lbs 4y.o.
12/15 crate rested
prednisone as of 12/15 relapse: 5mg 2x/day for 7 days; 12/22 taper for: √12/24 pain; √12/25 weak legs neuro
VT Rx as of 12/29: 5mgs 2x/day for ▲14 days, 1/12 test taper for: _ pain; _ neuro
gabapentin 100mgs 3x/day
methocarbamol 125mgs 3x/day
hypericum [St. Johns Wort]
Pepcid AC 10mg 2x/day for duration of prednisone ]
He also said the high temperature on each occasion is likely because of pain and anxiety and doesn’t see a concern for it being anything more than that. Now that we have pain under control and he’s resting well I will check his temperature here at home to get a baseline.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Jan 1, 2024 19:01:52 GMT -7
Brittany, I'm so glad to hear he definitely has bladder control!! Don't know what is going on with seemingly lack of bowel control to hold it in until at a proper place. If he will allow you to express for poop, that can relieve his anxiety of finding poop where he sleeps. Does he have normal firm poops, or a degree of loose stool?
Prednisone causes thirst and the need to take him out to pee every 4 hrs or so. You'll just have to note how often he now needs to pee
Ok, with now a 14-day prednisone course, the taper date would be on Jan 12.
I have seen with my own eyes, the use of prednisone turning around in a matter of an hour nerve diminishment when dosed mere hours after the first sign. However once the damage has existed for many hours/days, then it will likely take time for the body to repair the damage. This is where the thinking more in terms of months rather than days/weeks comes in. For sure it would be great to see nerve repair prior to 1/12 pred taper. But do not not be disappointed if you do not see some. With still having bladder control and some but weak leg movements, over time he will be improving his back legs.
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Post by Brittany & Oakely on Jan 2, 2024 22:12:41 GMT -7
Oakley took a very tiny step [1/2/24] today with support from a sling!! He was still knuckle down but I think that’s a great start!
I was able to express for poop today twice and he went immediately outside both times. Thank you so much for that video, it’s a huge relief to all of us for him to go poop outside and keep a clean bed.
He's been in really great spirits the last day. He did seem to have a decrease in appetite. He’s leaving a little food behind at breakfast and lunch.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Jan 3, 2024 12:09:56 GMT -7
Brittany, thanks for sharing a wonderful update. You are so on top of things! Indeed, an excellent improvement in nerve repair to have the ability to move legs in a walking motion with support of a sling. Good job on expressing for poop! As long as he is eating a pretty normal amount that is good. Monitor that he does not go in the direction of not interested in eating. Often Pepcid AC alone is enough to protect the stomach from acids, when that is not the case, keep in mind to talk about Rxing sucralfate in addition to the Pepcid AC. Sucralfate works in a different way than Pepcid AC to protect. SUCRALFATE |
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Post by Brittany & Oakely on Jan 7, 2024 17:07:18 GMT -7
Update: 1/7
Oakley is showing lots of improvements! Eating normally again and also gaining more strength. He is able to stand up on his own and support himself. He can take a small unassisted step to his water in his crate. The occasional accident of poo if he gets anxious and just doesn’t have the muscle tone to hold it.
Medications are still the same
Prednisone 5mg every 12hrs
Pepcid AC 10mg every 12hrs (30mins before prednisone)
Gabapentin 100mg every 8hrs
▲Methocarbamol 250mg every 8hrs
[MED LIST/HISTORY- Moderator's Note. Please do not edit
21lbs 4y.o.
12/15 crate rested
prednisone as of 12/15 relapse: 5mg 2x/day for 7 days; 12/22 taper for: √12/24 pain; √12/25 weak legs neuro
VT Rx as of 12/29: 5mgs 2x/day for ▲14 days, 1/12 test taper for: _ pain; _ neuro
gabapentin 100mgs 3x/day
methocarbamol ▲250mgs 3x/day
hypericum [St. Johns Wort]
Pepcid AC 10mg 2x/day for duration of prednisone ]
We will begin weaning prednisone 1/12 (14 days). I’m nervous to wean and stop the others. This is when we saw regression and severe pain begin last time
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Jan 7, 2024 18:11:51 GMT -7
Brittany, love hearing able to take an unassisted footstep.
Let us know if the hypericum, methocarbamol and gabapentin will also be stopped on same day Prednisone starts tapering (Friday, Jan 12).
No need to be nervous with the pred taper. It is needed to give proof if all swelling is actually gone, or if another pred course is needed. So far Oakely has had a 7- and a 14-day course. So after 21 days total up at the anti-inflammatory level, that just may be enough time for pred to do it's job. Everyone just needs to wait and see the results of the taper. Since taper is taking place on a Friday, make sure you are prepared with enough extra med doses on the outside chance pain might surface when vet is not open. My fingers are again crossed you will see no pain on the taper.
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Post by Brittany & Oakely on Jan 11, 2024 20:04:49 GMT -7
We have already stopped hypericum and methocarbamol.
Gabapentin [& pred] will be stopped 1/12 as well as the prednisone!
[MED LIST/HISTORY- Moderator's Note. Please do not edit
21lbs 4y.o.
12/15 crate rested
prednisone as of 12/15 relapse: 5mg 2x/day for 7 days; 12/22 taper for: √12/24 pain; √12/25 weak legs neuro
VT Rx as of 12/29: 5mgs 2x/day for ▲14 days, 1/12 test taper for: _ pain; _ neuro
gabapentin 100mgs 3x/day to be stopped 1/12
Pepcid AC 10mg 2x/day for duration of prednisone ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Jan 11, 2024 20:54:33 GMT -7
Brittany, you make no mention of any pain indications with the already stopping methocarbamol and hypericum. Hope that is the case.
If so, sounds as though a good possibility for a sucessful pred taper. Meaning no pain surfaces and no new neuro diminishment on the pred taper along with also stopping gabapentin. We await hearing the final proof when there are no meds on board: no pain surfaces and no set back in neuro the improvement you've already reported. Keep us posted, we will be waiting to hear the latest about Oakely!
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Post by Brittany & Oakely on Jan 23, 2024 11:41:21 GMT -7
It’s been a week and a half now of no pain medication and taper of prednisone. Oakley is taking 5mg of prednisone once a day along with 10mg of pepcid AC once a day. He’s doing fantastic! No signs of pain and neuro function continues to improve. He’s actually able to walk on his own and isn’t knuckle down anymore. We will taper prednisone further 1/26 to once every other day for a week. Crate rest will end 2/9. His activity will continue to be limited after that point (no jumping, no stairs, very short walks, no running, no furniture and kept on carpeted surfaces)
I cannot express my thanks enough for all of your help! It is so very appreciated.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Jan 23, 2024 12:20:06 GMT -7
Britanny, you brightened my day reading there is neuro repair improvement during the pred taper! Oakely is doing well under your wonderful care... keep up the good work. Often because nerves are so slow to self repair, it is the disc healing that happens first over the course of 8 weeks. Then nerve repair, taking even up to a year to self repair. Your Oakley is on a roll!!!
Will will be waiting for the final pred taper dose for the full truth about swelling. Sure sounding very positive for Graduation day to be Feb 5.
On graduation day (Feb 5) we will be watching for an update, that we can base our comments on. Then we will have lots to share with you on how to do that important and slow and gradual increase of activity back to family life. And how to handle stuff for the many happy years ahead with Oakely. You know things like dentals, trimming nails for health, and just having fun with him and more.
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Post by Brittany & Oakely on Feb 11, 2024 20:12:34 GMT -7
A little late on a response but Oakley continues to thrive! He’s been off of Prednisone completely for a week now.
i.postimg.cc/gcQc1xVY/GRADUATE.jpg ** We have allowed him out of the crate for short periods multiple times a day on carpeted floor. He wants to be in the crate and goes back in on his own. Still carrying him in and out to potty until we can get a ramp for the stairs outside. We have baby gates at the stairs indoors and aren’t leaving him unattended so he won’t get a wild hair and jump on any furniture. He seems to have gained some weight over this course and is looking quite chunky. Which I know isn’t good for the back. What kind of mild exercise would he be allowed to do and at one point? He doesn’t seem to have much of an appetite since stopping the prednisone and is eating 1/3-1/2 of his normal kibble. He had his first bath yesterday 2/10. We placed a towel in the tub and kept him steady. I held him still when he would try to shake any water off. He seemed to really enjoy it. Still no signs of pain and his walking continues to get less wobbly. We’re so proud of him and my toddler is so happy to have her “oakie bud” back! |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Feb 11, 2024 21:23:49 GMT -7
Brittany, you did it! Cared for Oakely to ensure his disc has healed. Now comes the time to gradually introduce him back to family life. GRADUATION, A SLOW RE-INTRODUCTION Determine how you are going to ease back into more normal activity at graduation from rest. The idea is to gradually give more freedom under controlled conditions. Not free rein of the house and yard immediately! LOL Your Oakely's muscles are soft and out of shape after the rest period. Take a look at our information. Gradually building your dog's muscles over a month's time will have him safely running, having fun again! SAMPLE SCHEDULE Here is a sample schedule to safely and slowly introduce your dog back to family life and physical activity: www.dodgerslist.com/2020/06/15/back-friendly/?highlight=sample%20scheduleDIY back PROTECTION around the house  ** 1) Good ideas in making your home back friendly: dodgerslist.com/2020/07/09/home-protect-ivdd-backs/2) Ideas and products to provide improved traction for wobbly legs especially on smooth floors: www.dodgerslist.com/2022/10/08/traction-solution-improvements/3) Teach him to be safe and not jumping up or down, but to use a ramp whether over steps leading outdoors or to furniture in the house. Dogs are best at visual learning rather than verbal commands. Dog trainer Anna Jane Grossman says “Dogs learn in pictures. Inside your dog’s brain is a very simple algorithm – pleasant images in one place and unpleasant images in another."
HAPPY DAYS AHEAD 1) You and Oakley have survived a disc herniation! Learn what you can do from this point forward. 🚩 www.dodgerslist.com/2020/05/20/ivdd-primer-living-with-ivdd2) Lots more ideas and tips in living with an IVDD dog such as dentals, nail trims, safe ways to have fun together, and more: 🚩 www.dodgerslist.com/living-with-ivdd-tips-2 PT THERAPY AT CLINIC or HOME Safety first. You should always consult with a veterinarian before starting any exercise program with your dog. -- Water therapy at home when weather is warmer for an outdoors kiddies pool: www.dodgerslist.com/2020/05/28/surgery-dog-water-therapy-- Strengthening core muscles. This applies not just for humans, but REALLY applies to the IVDD dog: "...improve the strength and coordination of the muscles that surround the spine so they can act like the world's greatest back and neck brace." www.spineuniverse.com/conditions/spondylosis Core exercises don't require specialized equipment. These are 4 exercises you can do at home: 1) Sit toStand, 2) Down to Stand, 3) Three Leg Stand, 4) Backing UP. ⚠️The last, HIP extension, exercise is NOT for dogs with IVDD back disease! May we turn the tables and ask YOU for help? Did you know there are less than a handful who volunteer daily to help dogs and their owners? We need helping hands from other Forum members in educating. Education about disc disease is our number one mission! We invite you to hop on to our educational bandwagon team. Too many dogs are put to sleep because owners lack education about IVDD treatment. STRICT crate rest and proper medication have helped many dogs recover. We depend on all members to pay it forward for the help they have received with their dog by helping us educate! Pick what suits you....
We depend on you. Here are some ways to help..  ** -- Please celebrate Oakely's graduation! Add a graduation photo and a short caption to our Gallery to give other members inspiration about your IVDD Survivor! dodgerslist.boards.net/thread/2262/add-dog-dodgerslist-photo-gallery-- "Share" our FB posts www.facebook.com/Dodgerslist-- When in conversation at the grocery store line or wherever you may meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas, Frenchies) give out our free little wallet cards. Hand carry our literature and print out our letter of introduction for your vet. for your vet and wallet cards for you And finally, don't be a stranger! Stop in periodically. We really do love to hear how your dog is doing. We'd love a short video clip to see Oakley in action at home, at PT and living & loving life in spite of IVDD! If you see a new member in a tough spot, give them hope. A brief paragraph about your dog can be insanely supportive and inspiring in a time of need!  |
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