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Post by Allison & Bugsy on Mar 23, 2024 6:40:39 GMT -7
[orig subject line: 9 weeks of crate rest, next steps] My name is Allison, and I have a 7 year old blue heeler (Bugsy) diagnosed with IVDD in February (T13, L1, L2). He's been on crate rest with prednisone and pepcid for 9 weeks now. It had worked, but on the day of his checkup 3 weeks ago,
[3/2] someone let him out of the crate unsupervised with our other heelers. It was just enough to reinjure the back...so more crate rest, more prednisone and some gabapentin. He entered crate rest with muscle spasms and wobbly walking. That went away until the reinjury.
[MED LIST/HISTORY- Moderator's Note. Please do not edit 34 lbs 7 y.o 3/1 disc relapse "involuntary movement" (possible new nerve damage?) in his back leg after an unsupervised release from crate. prednisone as of 1/24 : 10mgs 2x/day for 5 days, 1/29 test taper for:_pain / _neuro as of 3/1: IV prednisone for 1 day as of 3/2: 10mgs 2x/day for 7 days, currently EOD to end 3/28 gabapentin 100mg 1x/day Bugsy needs GI tract protector, Pepcid AC, on board for duration of Prednisone! ]
Now the spasms are back intermittently. One issue is that he doesn't like having the other dogs nearby and goes into guard dog mode. Also, others still let him walk a little outside during potty breaks and on the laminate floor on the way from the crate to the door. Another issue is the fact that he jumps up when I bend down to pick him up, and I think that's putting too much pressure on his back.
Here are my questions. 1. How do you stop the dog from jumping up (like he's assisting me with the pics up)?
2. At what point is it time to consult a neurologist? I'm not ready to do surgery because I'm concerned about after care. Certain individuals in my home refuse to follow the instructions now. I'm not sure I'm willing to put the dog through the trauma of surgery just to come back to the same situation.
3. Is it worth a consult with a neurologist now? I like my vet, and she has a lot of experience with heelers and IVDD. She's not convinced surgery is the right move now.
4. He's restless. I've started giving him some calming chews, but I wonder if I should ask the vet for something to help calm him.
Thanks!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Mar 23, 2024 10:20:56 GMT -7
Allison, welcome to the Forum we are glad you have joined! If you can fill us in on some important details, that would help us to give the quickest of help. See the questions at the end. In the meantime here is what is of utmost importance. 1. The single most important of care is the limited movement the recovery suite provides to healing the disc. Please have your other family members get up to speed on this disease so they, too, can be on board to help Bugsy heal his disc and get back to enjoying life. He is ONE VERY LUCKY dog to not have relapsed to nerve function loss. PROBLEM SOLVING🚩Pain Intermittent pain is not acceptable! Until we know the details of the med list, here is information you can use to advocate for Bugsy. Resolution of spinal cord inflammation/swelling provides the relief from pain. It can take an anti-inflammatory (steroid or a non-steriodal NSAID) a range of 7 to 30 days before all swelling is gone.
Meanwhile, 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.)
Adjusting meds by phone avoids a risky-to-the disc car transport into the vet. -- Describe on the phone the pain that you're seeing. --Advocate for the three pain meds @ 3x/day dosing PLUS a stomach protector such as Pepcid AC (Famotidine) to protect against the side effects of the anti-inflammatory. Learn about stomach protection including Pepcid AC dose and where to find it: dodgerslist.com/2020/05/06/stomach-protection/
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. Let us know all of the signs of pain you observe 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
🚩HelpersThis time with now having to starting back at square one of 8 weeks of rest and limited movement, let's make sure that disc will not be disrupted in healing. Bugsy deserves better. 3 Tools to inform everyone who cares for Bugsy 1) Conservative Road Map taped to FridgeVIEW, DOWNLOAD and print: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf 2) This is what can happen with too much movement to the early healing disc. 3) 10 mins to understand your dog's disease dodgerslist.com/2020/06/26/time-and-ivdd/
Most surgeons would not want to incur the risk that any surgery would have on especially for a dog who can walk. Even if the walking might be wobbly.
🚩Walking too much at potty time If Bugsy is in the range of 30-50 lbs it may not be easy to carry him for you and helpers. If that is the case there are options summarized below. This page has the full details of large breed care tips: dodgerslist.com/2022/02/10/large-dog-care-tips-ivdd/ --Place the recovery suite the very nearest to your door as possible for minimal footsteps in getting outdoors. --Roll a recovery suite crate to the sliding glass door where he will be able to take just the very fewest of footsteps to some snow, a patch of sod or astro turf to potty on the deck. --Place a pee pad where he can take a footstep or two out of the recovery suite onto a pee pad. For safety and control he would be harnessed and leashed! -- put down a rug runner on smooth floors for better traction. Best to avoid him walking anywhere as it is too much movement for the healing disc.
🚩 JUMPING UP Place a blanket draped down over the sides of the recovery suite. If he's to try jump up, he'll jump up in to darkness of the blanket. That should extinguish jumping pretty fast. Attach the leash to his harness inside of the recovery suite. Then it will just a few footsteps to an adjacent pee pad.
🚩 BEST BUDS At potty time, no other dogs should be allowed in the vicinity. And if it upsets Bugsy, keep them away from his recovery suite. For dogs the inborn instinct about weakness is for survival protection of the pack as a whole. There are two things that can happen in pack dynamics when a dog has been or is sick. 1. The healthy one may try to eliminate the weaker in the pack. 2. For the sick one, now the weaker in the pack to become more protective and aggressive because they know they are weaker now and may be subject to being attacked.
🚩 HELP TO RELAX IN SUITE Using any oral calmer can take 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
QUESTIONS1. Bugsy's weight?2. Prednisone: Start date? ?mg ?x/day for how many days? after which dose begins to taper3. gabapentin currently: ?mg ?x/day 4. Pain: do you see any other signs than muscle spasms? When: nearing next dose of gabapentin? Or when having to move (shift positions, potty time)? 5. Describe any signs of neuro diminishment: wobbly legs? paws knuckle under?
Let us know which suggestions made are working for your family. And if there are any other areas of concern we might comment on.
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Post by Allison & Bugsy on Mar 23, 2024 12:56:24 GMT -7
Thank you! I'm so glad I found this forum and for all of this helpful information.
Here are the answers to the questions. 1. Bugsy weighs 34 pounds.
2. Prednisone: 10 mg every other day because we're at the tapering part. He's been on prednisone since Jan. 24. He started with 10 mg every 12 hours, then every day. Now every other day. He has 4 pills left.
3. Gabapentin: He's been taking 100 mg at a time. It was every 12 hours, but I pulled back to once a day. He has 3 capsules left.
4. Pain: I haven't noticed signs of pain lately. He rolls over on his back to sleep regularly. The muscle spasms happen after he's jumped aggressively at another dog in the house, after the incident when he was slipping around on the laminate floor, or when he moved quickly in in circle during a potty break. I haven't looked to see when they occur around the gabapentin schedule.
5. Describe any signs of neuro diminishment: His back legs are sometimes wobbly. His paws DO NOT knuckle under. I know we're lucky he's still been able to walk and stand. He's actually had 2 reinjuries in the last 3 weeks.
Conservative treatment worked well. He responded well to the strict crate rest. After 5 weeks, he had more strength in his legs. Too much movement has not been good. Neither have sudden movements. Keeping him off slippery floors has been good.
His recovery suite is a wire crate, so he enters and exits from the front. (I tried him in a pen, but he kept jumping to try to get attention.) I put a bath mat in front of the crate door because of the anti-slip backing. When he exits the crate he stands there while I fasten a leash to the harness and pick him up to carry him outside.
We've been allowing some sniffing, but it sounds like we need to go back to strict rest. It also sounds like I need to call the vet for more meds.
Thank you, again.
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Post by Romy & Frankie on Mar 23, 2024 13:33:16 GMT -7
More meds may not be needed. You mention that Bugsy has not shown any signs of pain recently. During a pred taper, if signs of pain are seen, there is still swelling of the spinal cord. It is this swelling that causes the pain and neuro deficits like wobbly walking. Once the gabapentin, which may mask pain, is finished, you will be able to tell if there is still swelling and a need for more time on the full dose of the pred because you will see signs of pain.
Pred and other anti-inflammatories work on spinal cord swelling but if nerves have already been damaged and there are neuro deficits, anti-inflammatories can not help. What helps the nerves to heal is simply time. So signs of pain during the taper or an increase in neuro deficits are indicators that more time on a full dose of pred is needed. A continuation of wobbly walking does not mean more time on pred is needed.
It is so important to continue the very strict crate rest for Bugsy. Immobility is what allows the disc to heal. Maybe other members of your household can learn the importance of this by reading some of the info on Dodgerslist.
The picture below shows how you can use an ex-pen during pottying to strictly limit movement.
Slippery floors can be a problem for dogs during and even after an IVDD episode. Bugsy should not be walking much at all, but the use of runners and even yoga mats can help him get traction for the very few steps he might on rare occasions need to be taking.
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Post by Allison & Bugsy on Mar 23, 2024 17:44:05 GMT -7
I picked up the Adaptin pheromones. Tonight, 3/23 Bugsy's back leg collapsed when he walked out of the crate. I tried to prevent the jumping, and he still tried. Eventually, I figured out to hold his neck enough to prevent the jump.
I took him out. His back leg collapsed again when I put him down. He stood up and was able to pee. Then he took a couple of steps. He tried to pick some flowers, and I picked him up to take him back in. He adjusted his body weight as I lifted, and he slid forward out of my arms. I was still low enough that he didn't fall far, and I was still holding his back end.
I brought him inside and put him on the mat in front of his crate. He walked inside, turned around, and sat down. I noticed his penis is showing, which the vet said was a sign of nerve damage. He stood up to adjust his position, and I saw the back leg jolt a little. He sat down.
What I call a muscle spasm is that involuntary movement in his back leg. That was what was happening when I first took him to the emergency vet in January.
I'm a wreck right now. My gut tells me to try to keep him calm and not moving. I've been here before with him, and that's what worked. I just want to do what's right for him.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Mar 23, 2024 20:54:46 GMT -7
Allison, ah gosh darn about slipping from your hands. Potty time is too dangerous for Bugsy's disc. Time to upgrade safety for Bugsy! Potty time safety upgrade.-- Take your ex-pen to form a small area for potty time at front door of his crate in your home. -- You will be inside the ex-pen enclosure at potty time. -- Open the crate door. -- Bugsy walks out into the ex-pen enclosure to a pee pad you have pre-treated with a piece of urine soaked paper towel to encourage him to sniff and pee there. -- Use a sling for his back legs since he is wobbly. His healing disc can't afford his butt tipping or falling over. -- When potty time is over, Bugsy walks into his crate. Consider tossing a small treat to the back of the crate to encourage him to go in. --Fold up the ex-pen panels til next potty time. PenisMake sure the penis is going back in and not drying out. Use KY jelly or some water on clean hands to flick some water and help retract penis.PREDNISONESome information seems to be missing with prednisone use. Maybe you can clear up why gabapentin is still on board? So this is how the taper usually works and the reason why. -- Vet makes a guess of a 7- or 14-day course of prednisone, THEN it tapers. -- On the pred taper date is the time to also stop pain meds that block your ability to observe and report if pain surfaces. With gabapentin still on board, you and your vet have no idea if pred fully did its job.
RULE OF THUMB on a prednisone taper pain = swelling = another course of pred back at the original anti-inflammatory dose +pain meds and Pepcid AC
no pain = go to conclusion of pred taper No pain meds, just Pepcid AC for duration of pred. Finish out the 8 weeks of crate rest for the disc to heal
If you are not sure of pain, look to observe more than one sign of pain to confirm pain. For example: shivering could be he's cold or it can be pain. SIGNS OF PAIN: ⚙︎ 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 interested in life selves MONITORING NEURO FUNCTIONS during taperAs damage to the spinal cord increases, there can be a predictable stepwise deterioration of functions if excessive back/neck movement for example. 1. √1/24 Pain with initial tear of disc and ensuing swelling 2. √ 3/23 Wobbly walking legs cross 3. ___ Nails/toes scuffing floor 4. ___ Paws knuckle under. Dog is slow to correct or can't right the paw(s) at all 5. ___ Weak/little leg movement, ___ 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. QUESTIONS Prednisone: For how many days starting 1/24 did he take 10 mgs 2x/day?
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Post by Allison & Bugsy on Mar 24, 2024 3:31:40 GMT -7
He was on prednisone 10 mg 2x per day for 5 days. Then 1x per day for 5 days. Then every other day until gone. He now has 2 pills left. On 3/1 she also gave him a heavy dose of IV prednisone. I took him off the gabapentin because the vet seemed to think he didn't need it. I started giving him the gaba again when I saw the leg movements.
I set up the ex pen around the front of Bugsy's crate last night and covered it with sheets to give him some privacy. I slept there. This morning, his penis was not visible, which I take as a good sign.
I tried walking him out into the pen to use a pee pad, but he was not ready for that. He gets too excited when the other dogs are inside the house, so I will need to let them out first. I will try again because I do believe it's better for him to not be carried outside.
His leg moved involuntarily once, and his back collapsed. When he came back in, it happened again when he tried to turn too sharply. That's fewer times than last night. He's still eating and drinking water.
I emailed his vet during the night and am hoping she's working today. I'll call after they open this morning.
Current challenges are getting him to use the pee pad. The other dogs are a bit too chaotic when they're ready to go out. He likes to chime in with them.
Thank you so much for the support and advice. I am grateful.
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Post by Ann Brittain on Mar 24, 2024 7:05:34 GMT -7
It's a good idea to talk to vet.
Is there any way to isolate Bugsy from you other dogs? It seems they are causing him to want to be active. Over exertion could lengthen his recovery time or even cause a severe injury that he can't recover from.
I understand how stressful this is when you're trying to help your dog heal but with proper care Bugsy will get better.
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Post by Allison & Bugsy on Mar 24, 2024 8:34:02 GMT -7
I have an appointment with his vet first thing tomorrow morning. I am not bringing him with me because I'm not comfortable with the jostling in the car. If the vet feels it's safe,, I will bring him in later. I am recording videos of his movement. (The vet working today is the one who told me in January he pulled a muscle and put him on carprofen for a week.)
I have enough gabapentin to get him through the night. They did tell me to continue with the every other day prednisone dosage today, so he had 10 mg this morning.
I really don't have a way to separate him from the other dogs, but placing the pen in front of his crate and draping it with towels seems to help keep him calm. He's still taking calming chews and has the pheromones.
For now, he's resting. In the last 2 hours, he's gotten up three times to adjust position.
When I brought him in to the emergency clinic in January, he wasn't even willing to stand up. (He could stand and did in the clinic, but he didn't move at all in the car.) He is at least doing that now.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Mar 24, 2024 8:38:19 GMT -7
Allison, thank you for filling in missing information. This seems to be what actually happened with his treatment:
The important part of hormone prednisone is the 5-day course which works on inflammed tissue. The taper serves other purposes (test window for pain AND signal body to make its own cortisol steroid hormone again)
So basically due to the relapse of the disc due to strict rest interrupted by unsupervised release from his crate and your reporting pain, the previous Jan 24th 5-day course was for naught. Previous crate rest was for naught.
On 3/2 Bugsy started at square one with 8 weeks of STRICT rest and Prednisone IV (lasts for about 15-22 hrs). So he got a prednisone 1-day course on 3/2. And he resumed the every other day (EOD) pill tapering to signal the body to make its own steroid hormone.
Could you describe the details of what your eyes saw that means: "back leg moved involuntarily." Involuntary leg movements are likely not a sign of pain. --- Did he vocalize (yelp) with the leg movement? --- Or did he yelp upon the movement of collapsing downwards, hitting the floor? --- Paint us a picture of what you saw. If you can video it, that would be helpful too. Give us the link where you placed the video...say if you have a Facebook page. Or if on Youtube.
directions for mobile devices: Android or iPhone: USING THE PEE PAD -- Make sure at potty time there are no distractions of other dogs in the room. -- Ahead of time collect on a paper towel urine from one of your other male dogs. Store urine soaked towel in a zip lock bag in fridge. -- At potty time place the soaked papertowel on the pee pad. -- Command Bugsy to "go potty" as he sniffs. When he does pee praise lavishly. -- Give him a couple of minutes to potty. If he does nothing, back to his crate. Try again in an hour.
Bugsy is in your hospital. Just like in hospitals for people, visitors are not allowed to upset the patient. Do not allow your other dogs to upset or set a chaotic atmosphere. Just brainstorming ideas: -- Can the other dogs, for the time being, reside in another part of the house? -- Use a different door that wouldn't cause commotion. -- Let one dog out at a time?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Mar 24, 2024 8:46:34 GMT -7
Allison, good for you !!! To already understand that car transports are last resort for a real emergency. Too much potential especially for a heavy dog, that the early healing disc can be disturbed.
This makes no sense. Off the anti-inflammatory level of pred (whether 10mgs 2x/day) or the high IV pred. In the taper is time to test if all pain is gone. Gabapentin blind folds you. Neither your vet nor you know for sure if he need another pred course or should continue the EOD taper dose til about the28th?
It is not clear what "involuntary leg movement" looks like or means from this side of the computer screen. Look forward to you video or you painting us a picture. Leg movement does not sound like pain. What other signs to confirm pain do you observe from the list post several posts back?
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Post by Allison & Bugsy on Mar 24, 2024 13:21:44 GMT -7
I thought the second round of prednisone (started on 3/2 - injection was on 3/1). He was at the end of the first round at that time and was in pain.
I didn't pay attention and thought the prednisone was 2x per day for 10 days (like the first round). I caught this on day 7 and followed the directions from then on. He had 1x per day for 5 days. He's been on 10 mg every other day until the meds are gone, which should be 3/28.
I'm still watching for signs of pain. He doesn't yelp, but he grunts when you pick him up. He has been licking his paws. When I do the next potty break, I will record his movements.
His leg movement is that the leg sticks straight out behind him or slightly to the side. If he's standing, he'll correct this. If he's mid-step, his rear end collapses. He does not make any sound when this happens, but it does seem to startle him. He'll look up at me.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Mar 24, 2024 14:29:51 GMT -7
Allison, it is difficult to create an accurate med list from bits and pieces. If you want to correct Prednisone, we'd be happy for you to do it in list format as below: prednisone as of 1/24 : 10mgs 2x/day for 5 days as of 3/1: IV prednisone for 1 day as of 3/2: 10mgs 2x/day for 7 days, currently EOD to end 3/28-- grunting when picked up doesn't sound like pain -- (right or left?)leg sticking straight out or to side sounds like a degree of nerve damage. -- The dog below sits with legs straight out because he has fully lost neuro control of his legs. ** dodgerslist.com/wp-content/uploads/2020/04/Nerve-damage-leg-paralysis.jpgSame confusion about the gabapentin still remains....The pain med gabapentin blind folds you for correctly observing if pain still exists. Defeats the pred taper that can tell you. Neither your vet nor you know for sure if he needs another pred course (after a total of 13 days up at the anti-inflammatory level course) or should continue the EOD taper dose til about the 28th?
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Post by Allison & Bugsy on Apr 21, 2024 6:26:17 GMT -7
3/26/24 ▲Gabapentin, 100mg 2x/day for 25 days ✙Prednisone, 10 mg - 2x/day for 5 days, 1x/day for 5 days, 1x/every other day until gone (two pills left as of 4/21) ✙Famotidine, 20 mg 1x/day ✙Trazadone, 100mg 2x/day
[MED LIST/HISTORY- Moderator's Note. Please do not edit 34 lbs 7 y.o 3/1 disc relapse "involuntary movement" (possible new nerve damage?) in his back leg after an unsupervised release from crate. prednisone as of 1/24 : 10mgs 2x/day for 5 days, 1/29 test taper for:_pain / _neuro as of 3/1: IV prednisone for 1 day as of 3/2: 10mgs 2x/day for 7 days, currently EOD to end 3/28 ✙as of 3/26: 10mgs 2x/day for 5 days; 3/31 TEST TAPER for _pain? _neuro? ;final EOD dose on 4/21. gabapentin 100mg ▲2x/day ✙Trazadone, 100mg 2x/day ✙Famotidine 20mgs 1x/day]
Hi, everyone. Life has been chaotic for the last couple of weeks, and I've been super stressed about Bugsy. I did call the vet on 3/26 and was able to get meds for him. She agreed that it was a good idea to not bring him in.
I tried to get Bugsy to use a pee pad and even got the turf-style pads for him. He refused, so I have continued carrying him out.
We've not had another incident since he started taking the trazadone. It's also helped him stay calmer in the crate.
He'd been doing better and walking was more stable until 4/17. I'm not sure what happened, but his walking is now less stable. He can still stand and turn around in the crate. He tends to flop down when he goes to sit.
This morning (4/21), he peed and then his back legs gave out. I picked him up and brought him back to his crate. They gave out again, but he was able to stand and walk back into the crate. I wonder if the trazadone is partially responsible because he took it 3 hours before I took him I out. I usually give him the pill 1.5 hours before he goes out.
I'm still not entirely sure if he's in pain. I notice panting, but it's hot here and he's on trazadone.
I'm thinking about putting his crate on a table because I think it will be easier for me to pick him up. He still likes to jump up and stand on his back legs while waiting to be picked up, and I don't think this is good.
I'm having a hard time right now. I'm worried that I'm not doing what's right for him. I worry about him getting better. I'm scared about the prospect of surgery and afraid of what the vet will say tomorrow.
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Post by Ann Brittain on Apr 21, 2024 7:20:52 GMT -7
When you're a caring pet owner, it's hard not to worry when your dog is having IVDD issues. I'm really sorry to hear that you're going through this stressful time. It's hard not to worry, but you're doing what you need to do to help Bugsy heal.
Signs of pain can be different from one dog to the next. Sometimes it's a matter of knowing your dog well enough to understand when something doesn't seem right. Any change in "normal" behavior could indicate that Bugsy is uncomfortable or experiencing pain.
You mention that Bugsy is prone to try to jump. If the crate were on a table, and he managed to jump out, there would be a greater chance of an injury that would set his recovery back even more. Unless you can insure that can't happen, placing his crate on a table would not be a good plan.
Some dogs have an aversion to using a pee pad if they are used to relieving themselves outside. Keep in mind that you want to restrict his movements at potty time as much as possible.
And remember, Dodgerslist, is here to support you and your dog. We've all know how difficultl caring for an IVDD dog can be.
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Post by Allison & Bugsy on Apr 21, 2024 8:42:39 GMT -7
Thank you, Ann, for the pep talk. It helps to be reminded that I'm not alone in this process and that I am trying to do what's right for Bugsy. I also appreciate the caution about putting his crate on a table. I have hesitated going through with that plan because I don't want him to fall. Perhaps learning how to support him with a scarf is a better option.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 21, 2024 9:38:25 GMT -7
Allison, thank you for providing the important details on meds.
Understanding ahead of time about pred tapering lets you likely know the reason why....if you observe neuro diminishment to report things ASAP to the vet: "walking was more stable until 4/17"
On March 31st end of the 5-day pred course was the time to monitor AND alert your vet about any pain or neuro diminishment. ALERT your vet asap 1st thing Monday morning 4/22 about neuro diminishment you saw on 4/17 and still today 4/21!
Usually, another course of pred would be Rxd. So far he has had 4 different courses of pred adding up to a TOTAL of 18 days on the pred anti-inflammatory level. It can take up to 30 days for pred to get ALL of the swelling resolved. Taper days do not count in that 7-30 days range.
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Post by Allison & Bugsy on Apr 21, 2024 17:33:32 GMT -7
Bugsy saw the vet today [4/21]. The clinic is open 7 days a week, and she was on duty. She said he looks much better than he did the last time she saw him.
He is not in pain, according to her. We talked about the neuro diminishment. She recommended that we keep him on prednisone for now. 1x/day every other day [final EOD taper].
She suggested a rear harness and said we may need to consider a wheelchair to keep his back straight. He's not a good candidate for surgery because she's afraid he'll injured himself again as soon as he's feeling better. (She has a heeler with IVDD who has a similar disposition.)
The plan for now is to continue prednisone 10 mg 1x every other day and trazadone (100 mg 2x/day). The goal is to keep him as still as possible.
[MED LIST/HISTORY- Moderator's Note. Please do not edit 34 lbs 7 y.o 3/1 disc relapse "involuntary movement" (possible new nerve damage?) in his back leg after an unsupervised release from crate. prednisone as of 1/24 : 10mgs 2x/day for 5 days, 1/29 test taper for:_pain / _neuro as of 3/1: IV prednisone for 1 day as of 3/2: 10mgs 2x/day for 7 days as of 3/26: 10mgs 2x/day for 5 days; 3/31 TEST TAPER for _pain? √4/17neuro currently EOD to end 3/28 ;final EOD dose on 4/21. gabapentin 100mg ▲2x/day STOPPED 4/21 Trazadone, 100mg 2x/day Famotidine 20mgs 1x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 22, 2024 8:09:19 GMT -7
Allison, hmmm... a wheelchair would be used after graduation (Apr 27) only if the dog is not able to walk. Not as a means to keep the back straight.
A rear end sling for now and used at potty time would be to keep a wobbly butt from tipping over. Falling over could re-damage the still healing disc.
On the expected April 27 graduation day, we will be watching for your update on his neuro status, what med he is on if any. Then we can provide useful methods for safely and slowly re-introducing Bugsy back to family life.
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Post by Allison & Bugsy on May 16, 2024 18:54:25 GMT -7
Prednisone: 10 mg 1x every other day Gabapentin: 200 mg 3x/day as needed for pain Famotidine: 20 mg 1x every other day Trazadone: 100 mg 2x/day
On 5/2, I had to take Bugsy to the emergency clinic because he was clearly in pain, and had a mild case of paraphimosis. The vet prescribed him gabapentin for the pain and told me to apply lubricant to his penis if it looks like it's drying out. He also recommended an MRI so that we know for sure what we're dealing with. He said that he's never seen a case like this, that Bugsy should be showing signs of improvement or showing signs of more deficiency. His regular vet agrees and is willing to give me the referral for the MRI.
He does not have wobbly walking at the moment. As long as he walks slowly and doesn't try to make sudden movements, he's able to walk mostly normally. If he tries to walk too fast or makes sudden movements like a quick turn, his right leg looks like a jolt of electricity went through it. He'll sit for a moment before getting up again. I am still carrying him down steps and to his pee spot, but I was letting him walk 6 to 10 feet for a little movement. I use a sling most of the time when I take him out.
His legs do not cross. His nails/knuckles do not scrape the floor. He has bladder and bowel control. He wags his tail. I'm still keeping him on crate rest for now because it's still the safest place for him. I'm at a loss.
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Post by Allison & Bugsy on May 17, 2024 4:11:06 GMT -7
He was wobbly [5/17] this morning, and he fell back into a sit a couple of times during this morning's potty break.
✙Prednisone: 10 mg 1x every other day ▲Gabapentin: 200 mg 3x/day as needed for pain ▼Famotidine: 20 mg 1x every other day Trazadone: 100 mg 2x/day
[MED LIST/HISTORY- Moderator's Note. Please do not edit 34 lbs 7 y.o 3/1 disc relapse "involuntary movement" (possible new nerve damage?) in his back leg after an unsupervised release from crate. prednisone as of 1/24 : 10mgs 2x/day for 5 days, 1/29 test taper for:_pain / _neuro as of 3/1: IV prednisone for 1 day as of 3/2: 10mgs 2x/day for 7 days as of 3/26: 10mgs 2x/day for 5 days; 3/31 TEST TAPER for √5/2 pain √4/17neuro currently EOD to end 3/28 ; final EOD dose on 4/21. as of date? 10mgs EOD reported on 5/16! information missing gabapentin 100mg ▲3x/day Trazadone, 100mg 2x/day Famotidine 20mgs ▼EOD]
On 5/2, I had to take Bugsy to the emergency clinic because he was clearly in pain, and had a mild case of paraphimosis.
The vet prescribed him gabapentin for the pain and told me to apply lubricant to his penis if it looks like it's drying out. He also recommended an MRI so that we know for sure what we're dealing with. He said that he's never seen a case like this, that Bugsy should be showing signs of improvement or showing signs of more deficiency. His regular vet agrees and is willing to give me the referral for the MRI.
He does not have wobbly walking at the moment. As long as he walks slowly and doesn't try to make sudden movements, he's able to walk mostly normally. If he tries to walk too fast or makes sudden movements like a quick turn, his right leg looks like a jolt of electricity went through it. He'll sit for a moment before getting up again. I am still carrying him down steps and to his pee spot, but I was letting him walk 6 to 10 feet for a little movement. I use a sling most of the time when I take him out.
His legs do not cross. His nails/knuckles do not scrape the floor. He has bladder and bowel control. He wags his tail. I'm still keeping him on crate rest for now because it's still the safest place for him. I'm at a loss.
Last Edit: 12 hours ago by Allison & Bugsy: Added info about the sling.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on May 17, 2024 7:55:20 GMT -7
Allison, let us know the date you get for a neuro consult/MRI to rule out if there is another disease going on instead of a disc episode.
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Post by Allison & Bugsy on Jun 23, 2024 6:20:27 GMT -7
Good morning! Bugsy had a consult with a neurologist and an MRI on June 10. The doctor noted that his proprioceptive placing response is inconsistently delayed in his rear legs, but he is fully ambulatory. He has pain in his low back. His official diagnosis after the MRI was "Chronic L1-2 Intervertebral Disc Herniation with concern for gliosis and spinal cord atrophy +/- Concurrent chronic smoldering diskospondylitis at L1-2 and L2-3 vs. marked degenerative changes." The radiologist noted the following: ~ There's a problem in the spinal cord around the L1-2 vertebrae, but it's not getting worse or spreading. ~ The spinal cord is shrinking in that area. A disc in the spine is slightly bulging out, more to the right, without compressing the spinal cord but causing some inflammation around the area. ~ The most likely cause of the spinal cord issue is a previous injury to the cord, possibly from a high-speed impact or disc injury, leading to poor blood flow in the cord. ~ There is another non-compressive disc bulge at L2-3, with similar degenerative changes as at L1-2. ~ Mild swelling of lymph nodes in the lower abdomen is noted, likely as a reactive change. The neurologist said no running, jumping, or horseplay. She recommended physical therapy and laser treatment (NO chiropractic). No more using the sling. We are tapering him off the prednisone for now. Starting June 11, he had 5mg. every day. Starting June 18, he had 5 mg. every other day. Other meds (for the rest of his life):100 mg. gabapentin 2x per day 75 mg. amantadine 2x per day [MED LIST/HISTORY- Moderator's Note. Please do not edit 34 lbs 7 y.o 3/1 disc relapse "involuntary movement" (possible new nerve damage?) in his back leg after an unsupervised release from crate. MRI on June 10: Chronic L1-2; diskospondylitis at L1-2 and L2-3 prednisone as of 6/18 tapering EOD gabapentin 100mg ▲3x/day ] i.postimg.cc/gcQc1xVY/GRADUATE.jpg ** The challenge now is to re-integrate him into family life. He's not supposed to be unsupervised out of his crate. I suspect the other adult in my home has let him out and not prevented him from jumping on and off furniture. He's had the issue with his right rear leg sticking out a couple of times after jumping or trying to play with the other dogs.
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Post by Ann Brittain on Jun 23, 2024 6:56:03 GMT -7
It's good that Bugsy is able to get around, but concerning that he still has pain in his lower back.
As a dog shows signs of healing, it's easy to assume that he can resume 'normal' activities. But, due to the injury, precautions must be taken to prevent further damage. Allowing Bugsy to jump on and off furniture could cause another disc injury. I'm sure the other adult in your household loves him, but they need to understand how these activities could put Bugsy through more down time and pain, and the expense of veterinary care.
Laser therapy can be a helpful tool and physical therapy can help strengthen Bugsy's muscles. Swim therapy is also a low-impact activity that can help improve your dog's mobility.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Jun 23, 2024 16:06:47 GMT -7
Allison, now that you have good knowledge of what is going on with Bugsy, all members of the family can seek to accommodate Bugsy's needs for living with chronic disc issues.
Did the Neuro say never to be unsupervised out of the crate forever?
Or did the neuro mean always supervised when out of the crate while slowly over several months of gradually transitioning from the strict rest to getting back to a physical activity and family life?
Will you seek physical therapy at a rehab clinic? Or do you intend to provide physical exercises at home?
We await better understanding what the Neuro wants. And then we can offer you ideas which fit into your plans.
Let us know if the long term gabapentin/amantidine combo does a good job of controlling pain on a daily basis.
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