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Post by Sarah & Harper on Sept 15, 2024 21:16:50 GMT -7
[Original subject line: IVDD conservative management questions ] Hi, my dog, Harper, is 11 years 8 months old and late at night on aug 18, she yelped when I picked her up to bring her onto the bed and jumped off, hid under my bed. [8/18] ITHIS WAS 8/19 AT 5AM - I found her still under the bed at 5am shaking. I immediately got her out and noticed she was almost hopping on her back legs. Having difficulty walking. I thought maybe she had been bit by a spider or had broken a leg. I called the ER vets in my area but all said they were too busy and it would be hours. I was able to go to my personal vet a 9am who diagnosed Harper with IVDD. She said 2 weeks crate rest and meds (listed below). Prednisone daily for 5 days then tapered off for 4 days and gabapentin 7 days of at .6 ml at 50mg/ ml. Harper stopped shaking and panting after about 24 hours. [MED LIST/HISTORY- Moderator's Note. Please do not edit
13 lbs 12y.o in Dec
8/18 Dx IVDD but never Rx'd true conservative treatment
9/16 remains on pain med Gabapentin, legs cross, wobbly walks
Prednisone as of 8/19: 5mgs 1x/day for 5 days, then 8/24 TAPER TEST for _pain _neuro, final dose 9/2
Gabapentin 50mgs/1mL: 50mgs 2x/day]The doctor wanted to see her after 2 weeks, however I was in constant email contact. SINCE MY DOG WASNT PEEING OUTSIDE AND SHE IS TRAINED ON A WEE WEE PAD, THE VET TOLD ME TO HAVE HER GO IN A SMALL PEN AND PUT THE WEE WEE PAD IN THERE. So Harper was never just in a crate without a wee wee pad. She seemed to have ups and downs. Would get very excited if people came over or I was giving her food. Would try and jump up. Would fall bc back legs aren’t working awesome. sept 3 Went back to vet o (two weeks after initial visit), and vet said that she didn’t think Harper was in pain, but that she seemed to still have neurological damage and had “plateaued.” She suggested I start physical therapy asap, and put Harper on another 2 weeks of crate rest (however she told me to make Harper’s pen bigger so she had more room to get up and walk - still only a square in my living room), and reintroduce gabapentin 2 x a day. She also told me to take Harper on 5 min walks down my block to get her muscles moving. I did all of this and Harper seemed to be walking a bit better, but then she tried to jump up for a treat — on a leash, and fell on her butt, and it looked like her leg was hurt but she wasn’t shaking like last time. I decided myself to make the pen smaller (to what it is not - just a bed, water and food bowl, and a wee wee pad). I stopped the gentle 2-5 min walks (I have taken her out a few times to poop as she prefers to poop outside than on a pad inside). sept 9 I went to the physical therapist (1 week ago) for an examination of her muscles, joints, gait, etc. The PT vet seemed optimistic. She told me to keep Harper in the smaller pen, stop the walks (which I had done), and raise the gabapentin to 1ml 2-3 times a day, as she said since Harper’s back is hunched, she thinks there is still pain there. They did acupuncture on Harper and that seemed to help her. She also gave me at-home pain management (ice/ heat, red light therapy, gentle massage) + pt exercises to do daily. Toe pinching, knuckling and flipping over, and moving from side to side to strengthen core. All seem very gentle. Questions: I’ve read on here not to start PT until after 8 weeks but both my vet and physical therapist told me otherwise. I’m confused as to if I should do this or not… and if I should be doing the at-home exercises or not? I also did ask both doctors for another round of steroids for Harper and both said they didn’t think it was necessary. But her back is definitely still hunched… although she doesn’t seem to be in pain when I touch her. She also isn’t panting or shaking. Finally, neither doctor said 8 weeks crate rest. Vet wants to see her after 4 weeks, physical therapist wants her to come in once a week and wants to keep her confined for 8 weeks but open the pen to make it bigger at 6 weeks. Thoughts on all and any other info greatly appreciated as this is my first time going through this and I had no idea if I was making things worse or better — I was following my vet’s advice. *** [aug 17] THIS WAS 8/18, NOT 8/17 - also the day before this happened (the THIS HAPPENED I was referring to was finding Harper shaking and panting under my bed on 8/19 at 5am) I believe Harper fell going up the stairs… I didn’t see it but I heard a crash. When she got upstairs she seemed fine, but she immediately pooped like she was scared. Then we went on a .9 mile walk and she was in great spirits. It wasn’t until later that night before bed when I picked her up that she yelped and then darted off of my bed and all of the shaking began. The doctor thinks there was trauma also because one of her teeth is loose and jutting out of the front of her mouth. It wasn’t like that before.  Thanks for all feedback. ☆ 1 Is there still currently pain? ☐ reluctant to move much in crate such as shift positions or slow, ginger movements ☐ Arched back YES ☐head held high or nose to the ground ★2 13 LBS Age? WILL BE 1 2 IN DECGABAPENTIN - 50mg per ml; 1ml 2x a day (9am and 6pm) B.. Prednisone 5 mg - start - aug 19 - aug 23 1 x a day Then every other day from aug 25 - sept 1 ☆ 4 Mutt, mom was a dauchsun chihuahua, don’t know what dad was. Harper. Sarah ☆ 5 diagnosis IVDD Yes🔘 -- Is the vet a general DVM? YesAlso saw a specialist vet of physical therapy per my primary vet’s recommendation. Same diagnosis. ☆ 7 🔘 bladder control? Yes ☆ 8 Currently can your dog wobbly walk? move the legs at all? or wag the tail when you specifically do some happy talk? Yes to all, but she crosses her legs sometimes and her walk is definitely stiff on back legs and wobbly.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 16, 2024 8:14:39 GMT -7
Sarah, welcome to the Forum. We align with vets and other professionals in helping to teach other vets and dog owners about IVDD/home care. Check out their comments. In a nutshell this is how conservative treatment works: 1. Diagnosis by a vet to confirm IVDD. 2. STRICT rest for 8 weeks to allow the disc to heal, no pt, no walking around. 3. Anti-inflammatory prednisone to resolve all painful swelling around the cord. 4. Pain meds only needed while prednisone working on root cause of pain. 5. The 8/24 Pred TEST TAPER was to be the proof whether painful swelling exits and whether another course of pred was needed. 6. Pain meds are stopped on the pred taper so the owner is not blindfolded about existence of pain and whether another pred course is needed. It can take 7 to 30 days of pred to fully resolve pain. Pred taper days are not counted in the 7-30 days range as they are too low to work on swelling. Not all vets nor PT persons are comfortable about their knowledge of IVDD. Conservative care during a disc episode is not rocket science. Any owner can get up to speed quickly. This puts the pet owner into position to advocate for their furry friend, know how to hire the right vet to be on their dog's IVDD care team, etc. The important thing now is that further damage to an early healing disc is going to be prevented from any more damage. There is no way around it....TRUE, STRICT rest is how that happens. Please confirm that you are on the same page as to TRUE, STRICT conservative care. 🟣 STRICT REST means ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy WHYs: dodgerslist.com/chiropractic/◼︎no walking around, meandering at potty times. ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎Attach water/food bowls inside recovery suite. ◼︎How to set up proper size mattress system for the suite plus many other tips in carrying out STRICT REST/limited movement of back: 🚩 dodgerslist.com/strict-rest-recovery-process/◼︎ Car transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. Vets who know IVDD often take phone updates & adjust meds via a phone call.
◼︎ Roadmap for your fridge. Stay the course, avoid dangerous detours for the healing disc: 🚩 dodgerslist.com/wp-content/uploads/2023/12/Roadmap-for-Fridge.pdfPOTTY TIME strictness Carry your dog to and from the recovery suite to the potty place and then allow a very, very few limited footsteps if Harper only wants to poop when outdoors. 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. Place the pee pad adjacent to the recovery suite (not in the suite). Lift and place Harper on the pee pad. Allow a few footsteps to take care of business.  Questions and updates 1) Gabapentin is effective for 8 hrs. Currently is pain in full controll night and day with your dosing every 12 hours? Any signs of pain nearing the next 12 hrs dose? If in pain, do the every 8 hrs (3x/day) as Rx'd. A typical Rx is for a 3-way pain med combo 3x/day: (traMADol for overall analgesia, gabapentin for nerve pain and methocarbamol for muscle spasm pain). 2) His pain and the need for gabapentin may well be due to a set back in healing of increased tears to the disc with all the excessive movement. 3) The time to strengthen the core, do massage, toe pinching, go on walks is after the damaged disc has safely been healed on graduation day of Nov 11. You can play an instrumental part in Harper's disc healing when you educate yourself, are able to discuss and ask questions about treatments from the well intended. Dr. Nancy Kay, DVM, ACVIM has hit it on the nail especially with IVDD. Each of us needs to be self educated so we can team up to work with your vet. "Gone are the days when you simply followed your vet's orders and asked few, if any questions. The vet is now a member of your dog's health-care team, and you get to be the team captain!" READ MORE: www.speakingforspot.com/PDF/Medical%20Advocacy%20101.pdfOur hope is in the next few days you will have a chance to delve into the readings on our Main Webpage that we are linking to and be the prepared IVDD savvy owner your dog needs to be her advocate. Hopefully you can work with your current vet or find a 2nd opinion vet to find out if all the painful swelling is really gone and if not resolved... another 5-7 day or even a 14-day course of an anti-inflammatory along with pain med(s) while anti-inflammatory is at work. **  |
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Post by Sarah & Harper on Sept 16, 2024 10:21:47 GMT -7
She is not in any pain with or without gabapentin. The vet put her back on to help the nerves.
She will not pee or poop just by being placed on a wee wee pad. We tried that. It was a disaster. She wouldn’t go and I had to take her to a human doctor to get an ultrasound of her bladder. It was so full. She doesn’t go on command. Hence why the wee wee pad is IN the crate. Every vet I have spoken to said this is fine and is better bc then Harper isn’t stressed to be picked up and carried out every 2-3 hours.
In regards to PT you are saying not even to ice or do laser or acupuncture?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 16, 2024 18:03:44 GMT -7
Sarah, thanks for letting us know that no pain surfaced right up to the last pred taper dose on 9/2 without any gabapentin on board. Did I read correctly? Can you explain more about resuming gabapentin on 9/2 "to help with nerves?" What does "to help with nerves "mean? Gabapenin is used to prevent seizures or to block nerve pain as during a disc episode. The increase of gabapentin from 30mgs to 50mgs on 9/9 with back hunched sign of pain and not following true STRICT rest shout out quite a suspicious relapse to the early healing disc! IF there has, indeed, been a re-damage to the disc, getting an anti-inflammatory back on board is a protection to an inflammed, painful spinal cord. The sooner inflammtion is dealth with the better for the nerves in the spinal cord. If, indeed, the spinal cord is now inflammed, due to all the exposure to excessive NON CRATE REST therapies Rxd, the pain medications would be meds every 8 hrs to cover the usual 3 sources of disc episode type pain: traMADol as the general analgesic methocarbamol for muscle spasm pain gabapentin for nerve pain. POTTY TIME -- how to safely lift and carry Harper dodgerslist.com/back-support/-- She might be tempted to pee on pee pad outside of the suite every 4-6 hours unless she is on pred. Keep a small piece of urine stained paper towel in a zip lock bag in the fridge. Her urine or another dog's urine. At potty time when you kmow she should have to go, lift her out of her suite to the pee pad that has the stained paper towel on it. Let her sniff and see if she will release urine. If not, try again in 1-2 hrs. If that simply does not work, you may just have to go back to peed pad in her suite or take her outdoors on the grass to pee. True conserative treatment is all about no exercises, no PT, no massage, no toes pinching, no moving dog side to side. Those are things that can be safely done after graduation day NOV 11. Please give Harper every possible chance to heal her disc. You can be an instrumental part of her recovery by insuring STRICT rest. Save ALL, any vet visits for a true emergency. Emergency where the risk of too much movement with a car transport outweighs the potential risk of damage to the disc. PT is not an emergency. --- PT is for after graduation day --- Vets who know their IVDD will take a phone update, adjust meds over the phone to enable the dog to stay at home safely in the crate healing the disc. --- Advocate for pain meds and an anti-inflammatory to deal with inflammation caused by a relapsed disc due to exessive movement. If you do have an at-home red light device it might be an effective adjunct to pain meds and an anti-inflammatory drug. If you desire laser or acupuncture, then hire a mobile vet to come to your home. Limit car transports to a real emergency. |
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Post by Sarah & Harper on Sept 16, 2024 18:23:19 GMT -7
Thanks for getting back to me. I just mean that after the initial 7 days of gabapentin, she was off for 7 days before seeing the vet for a recheck and she wasn’t in any pain. When the vet saw her, she said “she doesn’t seem to be in pain, but since she is still walking wobbly, let’s put her back on gabapentin 1-2 x a day for management. Dogs do really well on this for the rest of their lives. It can help heal nerve damage.” She was essentially saying it could be something Harper is on for the rest of her life.
Idk — I took neurotin daily for over a year for nerve pain from an autoimmune disorder so it sounded legit to me.
I did ask the vet to give Harper more steroids — and I asked the vet specialist of PT who has a neuro and ortho background - and both declined.
Do you have an ivdd vet you can refer me to who can put Harper on the correct meds?
I definitely did not do strict crate rest as I tried taking her on gentle 2-5 min walks after 2 weeks of rest per my vet, but stopped that quickly.
She has been in a 48inch by 24inch crate since sept 7. I consider this strict crate rest. Do you?
It just has her bed, raised bowls, and a pee pad. I also have a very small crate that I crate trained her in that she does like to go in (about 22 in long - she’s about 18 inches when lying down straight), so I do put her in there daily for naps (especially when I am eating as Harper is very into food and gets too excited). She can’t stand up very well in there and when she gets over excited even in the small crate she tries to jump and hits her head on the top of the crate!
What would the ideal crate size be for Harper with and without a pee pad?
That way I can try to better accommodate. For example, she is in her pen sleeping soundly in her bed and will likely be like this until morning (she sleeps through the night very well as she is older). She does like to pee in the middle of the night so when I come downstairs between 6-8, there is pee on the pee pad, but she is always still in her bed. It’s more during the day that she gets overly excited. By ppl walking by, packages being dropped off, if someone comes into my house, if I eat, when I get her food, etc. She has always been a very spirited and excited dog so I am happy that she still has this zest for life (the first two days of the ivdd episode she only wanted to eat, but other than that, she seemed miserable. Only barked once in two days - it was so sad).
Anyway, would love your thoughts on ideal meds for Harper and I can try again with my vet. Alternatively, if you have a vet recommendation, that would be amazing.
I have stopped at home PT exercises, but have continued with the red light therapy (I do have this at home).
Can I do heat and ice as well?
Also ideal sizing for ex-pen with and without the pee pad is greatly appreciated. Thank you!
*** Also just for clarity, the last prednisone taper dose was 09/01. Correct, that gabapentin had not been used since Aug 25, and was resumed after follow-up vet visit on Sept 3. ***
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 17, 2024 10:42:07 GMT -7
Sarah, do you see the reason why no one knows what is going on with Harpers inflammation: -- There has been no proof at all by stopping both the gabapentin and the prednisone at the same time. Anytime pred is on board or gabapentin is on board, the body is not cleared of things that can help with pain. -- It is ONLY the pred taper where both pred starting to taper and eventually ending in every other day dose and the STOP of GABAPENTIN tell the truth. Pain signs may appear somewhere along the tapering of pred as it gets lower and lower. It is only at the final taper dose of pred along with no gabapentin in the system that one has proof if no pain exists anymore. "since she is still walking wobbly, let’s put her back on gabapentin 1-2 x a day" -- nerve damage of wobbly walking is not aided by a nerve pain med. In fact there are NO meds that heal nerves. Nerves heal all by themselves with time. "Dogs do really well on this [gabapentin] for the rest of their lives." ---All meds are poison. Use them when they have something to work on in the dose that is appropriate. For a disc episode the cause of pain is the inflammation. Painfully inflamed tissue around the cord is resolved not by pain meds, but by an anti-inflammatory such as prednisone or even a canine approved NSAID. Scroll backup to see the list of the two classes of anti-inflammatory drugs. What are the letter credentials of an "ortho and neuro background"? Right now things sound very suspicious re: why is there pain that needs ice, heat, red light and gabapentin. No proof of what is the root cause of this pain and yet people are prescribing for the unknown??? With proper pain meds on board and an anti-inflammatory drug for a relasped disc (no one has any proof of this) there would be no need of ice or heat, no need to be touching the spine. Since there is no proof of the cause of pain, it would seem a prudent thing to act as if there HAS BEEN a relapse to the disc with all the exercise Harper has been exposed to. That is STRICT rest, no vet visits unless it is a true emergency, pain meds and maybe a short anti-inflammatory course of 5-7 days to get to the bottom proving all disc caused pain in the spinal is actually gone. It would be best if you could work with your current vet over the phone to avoid a car transport in. A 2nd opinion vet who is not associated/influenced in any way with your current vet would require Harper be transported in for an exam and diagnosis. It would then be worth the risk to take Harper in to get the right diagnosis and get the right meds on board if indeed the 2nd opinion vet has a high suspicion of a disc issue causing cord inflammation. --- Only a very expensive $3000+ MRI can show soft tissue of disc and spinal cord. --- Xrays do not show disc and spinal cord, only hard tissue of bone, tumors, etc. X-ray are used to rule out if there is another highly suspicioned disease. X-rays do not proove a disc episode. The size of the recovery suite to provide limited movement of the spine: --- only large enough to stand on all four legs --- when lying down to be able to fully stretch out all legs. --- To be able to easily turn around in. --- pad out any extra area in the suite with a rolled up blanket as a bolster. This tip and more from: dodgerslist.com/strict-rest-recovery-process/ Drape a blanket over the crate til it reaches the height of Harper's eyes if she were sitting on her butt. If she would try to jump up on back legs, she will be in the dark. Soon the behavior of jumping up should be extinquished. Don't know your city/state. However, you might find a recommendation for a vet in our Member's Directory: dodgerslist.boards.net/board/13/member-reported-surgery-costs-recommendations I hope you have enough information to make changes for Harper's benefit at home and putting forth your concerns with any vet. Please don't hesitate to bring up any other things on your mind. |
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Post by Sarah & Harper on Sept 17, 2024 10:54:37 GMT -7
I’m doing the best I can. I have listened to my vet and specialist to a T.
Your tone is really aggressive. I’m not a doctor. I listened to what they said about meds. I came here looking for a safe space. Super disappointed in your aggressive response that feels like you are blaming me for doctors telling me to ice and heat and do laser and keep her on gab.
And then not even to answer my question about what meds she should be on. Aren’t you a vet?
This has been a very disheartening experience coming to this forum.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 17, 2024 12:58:57 GMT -7
Sarah, I hear you... about the conflicting information with Harper's IVDD. I'm upset with myself to have caused you any turmoil. Not the intention at all
None of us here are vets. My experience at Dodgerslist since my dog had a disc episode started in 2007, I have now seen over 50,000+ dog owners report about their dog, their dog's medicines and what their vets prescribe. With this vantage point patterns develop with "X" kind of care compared to true conservative treatment of medications and strict rest. Generally, cheating on the 8 weeks of strict rest causes a setback to the healing disc. Our goal here is to provide information to allow the dog every chance, every opportunity to heal the disc and not do any more damage to the spinal cord or any damage that could be permanent paralysis. And most of all to be able to go forward living many happy years ahead with their owners. The Neuro Corner DVM, ACVIM specialists have answered many questions for our community about IVDD plus an informtive interview. Two excellent resources we can refer to: -- The Neuro Corner: dodgerslist.com/neuro-corner/ -- Surgery and Conservative Treatment Interview dodgerslist.com/dr-isaacs-surgery-answers/I think most all of us love our vets. And they are very good at the daily things and diseases they treat. Not all vets know IVDD. Most DVMs in a general practice see many different species- hampsters, cats, all breeds of dogs, reptiles, birds, maybe even farm animals. They practice many specialties in the course of a day: pediatrics, dentistry, surgery, internal medicine. Is it surprising, that keeping current and indepth knowledge of each and every disease for every species is probably not likely? However YOU can easily become a mini-expert on one very-important-to-you disease. Now a days there is a wealth of IVDD information and Dodgerslist has put the care procedure in one place on the Web: www.dodgerslist.com
The Neuro Corner DVM, ACVIM specialists have answered many questions for our community about IVDD plus an informative interview. Two excellent resources we can refer to: -- The Neuro Corner: dodgerslist.com/neuro-corner/ -- Surgery and Conservative Treatment Interview dodgerslist.com/dr-isaacs-surgery-answers/Because we are not vets we do not prescribe medications. We can tell you name of the typical pain med combo and how long pain meds are effective for, we can tell you how an anti-inflammatory works during a disc episode to prepare you during its use. We can tell you what the signs of pain look like. It is you and your vet who determine the Rx and if adjustments are needed. You are the vet's eyes and ears to report pain over the phone to get meds adjusted. 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. The prednisone anti-inflammatory taper days do not count in the "7-30 day" range. Those taper doses are too low... taper days serve a different purpose.
The best pain medications control is using more than one approach to address pain from multiple fronts that are typical with a disc episode. These pain meds are effective for about 8 hrs (3x/day). -- traMADol-general analgesic -- methocarbamol- muscle spasm pain -- gabapentin-nerve pain). All three pain meds need to be prescribed three times a day.
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.
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
Our goal is to help you maneuver things that can be overwhelming with an IVDD diagnosis in caring for your dog. Getting quickly up to speed on intervertebral DISC disease helps you in understanding the why of what your vet advises and the ability to bring things to the table in working together to help heal the disc.
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Post by Romy & Frankie on Sept 17, 2024 13:28:39 GMT -7
I am very sorry if anything we wrote sounded aggressive. That would never be our intent. We are not vets, but after years on this Forum we know a lot about how IVDD is treated. As volunteer moderators, our only goal is to help dogs.
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Post by Sarah & Harper on Sept 17, 2024 13:54:44 GMT -7
Right but you’re writing with language that is aggressive, using multiple question marks, and capital letters which feels like you’re screaming and/or shaming me.
I have heard such great things about this thread from Reddit, and came over here to get advice on PT and instead I got shamed into not having my vet prescribe more steroids (which I’ve asked for, several times), and told that my dog is in pain and that I’m basically a bad mom for letting her be in pain - obviously I don’t want my dog to be in pain. Two vets would not prescribe me additional steroids. Both vets told me to do PT, and to start asap, and to heat and ice.
You are saying not to. You are also saying to get my dog more meds, but you can’t prescribe them because you are not a vet, and my vet won’t so what am I supposed to do?
You are also telling me not to let my dog move at all, but both vets said otherwise. They said it’s important for my dog to still stand and take a few steps, and as stated previously, one even said to take my dog on 2 min walks.
The IVDD handbook written by a rehab Vet in the UK says not to immobilize a dog recovering from ivdd. That this is detrimental to recovery. They have 5 star reviews and a website dedicated to IVDD.
So yes I am confused and wanted to get your insight, not be shamed.
Thank you.
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Post by Sarah & Harper on Sept 17, 2024 15:09:36 GMT -7
And I emailed my vet again this morning [9/17] and demanded another round of steroids. She spoke with the specialist and they just got back to me and will give her another round of ✙prednisone finally. I said I thought she reinjured herself from PT and I have decided to do another 8 weeks of crate rest.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
13 lbs 12y.o in Dec
8/18 Dx IVDD but never Rx'd true conservative treatment
Strict rest started on suspicion of a painful disc relapse on 9/16
9/16 remains on pain med Gabapentin, legs cross, wobbly walks
Prednisolone as of 8/19: 5mgs 1x/day for 5 days, then 8/24 TAPER TEST: √9/16 pain _neuro, final dose 9/2
✙as of 9/17: 5mg 1x/day for 5 days, Sun 9/22 TEST TAPER for _pain _ neuro
Gabapentin 50mgs/1mL: 50mgs 2x/day
Harper needs GI tract protector, Pepcid AC, on board for duration of Prednisone! ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 17, 2024 16:31:35 GMT -7
Sarah, kudos go to you for successfully advocating on behalf of Harper! Job well done. All caps here on this Forum does not mean we are shouting. Just for you I will try to avoid 'em! Please forgive me if I mess up. You may have noticed we write rather long posts chock full of info. We might use all caps or bold words so that it will be easy for you to re-find and re-read certain parts of our posts again if you wish. We also bold face your posts to be able to re-find important pieces of information you provide. This helps us because we re-read your old posts before making a reply. Do you live in the USA? Does the specialist have one of these credentials or something different used in other countries? --- Ortho (DVM, ACVS) --- Neuro (DVM, ACVIM) When you get the Pred script in hand, would you fill us in on the details so we can follow along and keep you informed of what to expect. 1. What date are you first giving Pred?
2. How many Pred mgs and how many times a day do you give that dose?
3. What is the last date you give this original pred dose? Then begins the all important test pred taper to verify if pain still exists or not.
Stomach protection to suppress acids caused by prednisone is typical: Pepcid AC.
If you do live outside the USA there are other acid suppressors that could be used. Let us know your country. Learn why stomach protection is valuable for the duration of Prednisone.
--- 3 reasons why stomach protection: dodgerslist.com/stomach-protection/
You and your vet are doing the prudent thing. Until you have proof there is no spinal cord swelling, the anti-inflammatory prednisone is used to eventually get all the painful swelling resolved. While pred is at work, pain is blocked by gabapentin and if need be other pain meds could be added. Harper deserves to heal in comfort while pred can take days (7-30 days) to resolve all painful swelling.
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Post by Sarah & Harper on Sept 17, 2024 16:46:29 GMT -7
***edit: Harper is on prednisolone, not prednisone. ***
Thank you. I live in the US. In Los Angeles, in fact. We have plenty of vets out here. I really like mine. I did ask about Pepcid and she said the prednisone does not affect the stomach and would not suggest giving Harper Pepcid so again I am confused. Last go around Harper didn’t take Pepcid and she didn’t have any complications.
first giving Pred? Today, sept 17 @ 4pm PST
5mg 1 x a day for 5 days, then half a pill (2.5 mg) 1 x a day for 5 days, then half a pill (2.5 mg) every other day for 5 days.
What is the last date you give this original pred dose? Do you mean the 5mg dose? Sept 21.
I know that you said tapering doesn’t count as a dose, I asked my vet this twice and both times she said this is how she prescribes for Harper’s size and condition. I tried to get her to do a 7 day dose, then taper, but she wouldn’t, again saying this is the most effective for Harper’s size and condition so idk what to do since, again, I am not a vet.
Can you please explain when I should stop gabapentin? Since as you know my vet would like me to keep Harper on it long term (at least 1x a day for the foreseeable future).
But I want to make sure I get her off of the gab when I remove the pred so that I can tell if she is still in pain.
Walking wobbly or crossing legs in the back does not indicate pain, or it does? I’m assuming that is neurological and may take much longer to repair.
Should she have no arched back by the end of the pred? If her back arches does that mean she is still in pain?
I’m trying to decipher what the noticeable pain signs will/ would be since she is not panting or shaking like she was a month ago, she isn’t moving away from my touch like she did a month ago. The only indication that she could be in pain would be the arched back…
Thank you for clarifying.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 17, 2024 20:00:30 GMT -7
Sarah, now we are rolling...thanks for the details on the meds. prednisolone / prednisonePrednisone is activated by the patient's liver into prednisolone. Your vet's Rx for Prednisolone means the body need not do any conversion. The Pred Rx and what to expect:Harper was prescribed a 5-day course of Pred, then a lowering (taper) of the medication. The opportunity to test for painful swelling begins after the 5-day course has been given. Then the pred taper begins on Sunday 9/22. For the taper opportunity to be meaningful, the pain med, gabapentin, would be stopped on Sunday 9/22. Without a gabapentin blindfold, you'd then be able to quickly and accurately be able to observe if any pain surfaces as the taper proceeds to conclude with a final every other day 2.5 mg dose on Oct 1. Observing for more than one sign of pain will help you to confirm pain. Scroll up to my previous post for listing of pain signs. We got our fingers crossed, that the taper will give proof right up to Oct 1 that all swelling in the cord is actually gone. Then all thats left is to finish out the crate rest. With an expected graduation date of Nov 11
Would you confirm if this is current for gabapentin dosing?
Gabapentin 50mgs/1mL: 50mgs 2x/day
I highly recommend keeping a med chart if you are not already doing so. The chart is very handy for noting dates, seeing patterns, and making sure no med is missed and for quality communications with your vet.
 **
Preparation for the Sunday 9/22 pred taperAs explained more fully in this recommended link: dodgerslist.com/steroids-vs-nsaids/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 at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free! Rule Of Thumb on Pred 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.
1. Let us know what you and your vet decided for the Plan B.... extra pred and pain pills on hand which you could dose back up on the original 5mg 1x/day anti-inflammatory level of Pred or an Rx you could fill at a 24hr pharmacy?
2.Please re-review the link on the 3 reasons why Pepcid AC. Harper doesn't need to be possibly subjected to bleeding ulcers on top of what she is already dealing with. ---- Use the tip of how to specifically ask: do make it a point to ask if your dog has any health issues that prevent the use of Pepcid AC (famotidine)? If there are no health issues, purchase Pepcid AC (famotidine) at the grocery store.
✅ Harper has all three of these: ✅ Stress can increase stomach acids. Dogs are creatures of routine.The change of needing to be in a recovery suite and suffering pain until pain meds can be prescribed are stressful to a dog. ✅ The use of any anti-inflammatory drug ( steroid or NSAID) can increase stomach acids. ✅ Spinal cord damage such as wobbly walking can inhibit the autonomic function that normally protects the stomach lining. Neuro corner answer on use of Pepcid AC during a disc episode: dodgerslist.com/anti-inflammatories-warrant-stomach-protection/What to expect re: nerve healing for Harper's wobbly walk, legs crossing: dodgerslist.com/nerve-healing-after-disc-episode/ |
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Post by Sarah & Harper on Sept 20, 2024 16:05:52 GMT -7
9/17:
Thank you for the info. I just emailed my vet again about Pepcid and asked if I can give it to Harper as a precaution - and I sent the link you sent me.
We shall see what she says.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
13 lbs 12y.o in Dec
8/18 Dx IVDD but never Rx'd true conservative treatment
Strict rest started on suspicion of a painful disc relapse on 9/16
9/16 remains on pain med gabapentin, legs cross, wobbly walks
Prednisolone as of 8/19: 5mgs 1x/day for 5 days, then 8/24 TAPER TEST: √9/16 pain _neuro, final dose 9/2
✙as of 9/17: 5mg 1x/day for 5 days, Sun 9/22 TEST TAPER for _pain _ neuro
Gabapentin 50mgs/1mL: 50mgs 2x/day, erratic ▲and ▼ dosing.
✙Pepcid AC 5mg 2x/day as of 9/18]
▲Gabapentin is 1ml of 50mg/ml 2-3 x a day. Today I gave her 3 x a day to get her to rest more. I will likely continue the three times a day until I taper the prednisolone… in an effort to get her to rest more.
Harper update:
Just gave her the 4th of 5 prednisone pills. She is currently devouring her dinner.
The vet said I could give ✙Pepcid although she doesn’t think Harper needs it. I’ve been giving it twice a day since [9/18] Wednesday.
I’ve upped Harper to ▲gabapentin 3 x a day .6 in the morning and 1ml for the other two doses. Yesterday she would NOT let me give her the gabapentin and was squirming and moving and overall annoyed off. I finally just put it with food in her bowl and I think she took it all because the bowl is dry. She also just seemed overall annoyed off and low energy yesterday.
However today [9/20] I went backn ▼gabapentin to 1ml 2 x a day. So far she seems in much better spirits.
Tomorrow [9/21] will be my last day using gabapentin, as the
pred taper starts [9/22] on Sunday (2.5 mg for 5 days, then 2.5 mg every other day for 3 days).
Or do I remove gab after the 2.5 for 5 days?
Also she has always shaken her entire body to get loose hair off of her coat and is still doing that. It’s pretty aggressive and violent. Especially when I take off her harness and when she gets up from lying down. Ie to drink water or change the direction of laying. She also sometimes furiously scratches her bed for like 3-5 min straight (again she’s always done this).
What should I do about these behaviors that aren’t very chill?
Thank you
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 20, 2024 19:39:22 GMT -7
Sarah, good job on getting Pepcid AC on board on 9/18. We LOVE dates!
Pepcid AC: how many mgs each dose? How many times a day? For a 13 lbs dog that ought to be 5mgs every 12 hours (2x/day)
Gabapentin. Best would be to find the dose that keeps pain at bay round the clock and stick with that dose. Does gabapentin 50mgs (1mL dose) 2x/day fully control pain?
RAMBUNCTIOUS BEHAVIOR
Sedative. if Harper is too rambunctious and not able to relax in her suite, then discuss with the vet about traZODone or other Rx to help.
If you can distract her from shaking by giving a command such as sit and then if she complies a teeny/tiny 1/2 pinky nail size treat. Maybe you can untrain her???? Dog's don't care about the size of the reward, just that that get one.
Can you take out the blanket that she is scratching on. Or if she is scratching the mattress, maybe a small light in weight synthetic polyester fleece would not take her very many scratches to re-arrange correctly? Again maybe giving a command to distract her would work here too? And if necessary a traZODone Rx would take the edge off enough she'd stop the rambunctious behavior?
PRED TAPER
-- Pred taper starts Sunday 9/22
-- Pain med gabapentin stops Sunday 9/22 so that you can correctly observe for pain should any pain re-surface. Our fingers are crossed that no where along the Pred tapering process will any pain surface. The final pred taper day will give you proof positive if Pred has fully completed its job to resolve all painful swelling.
--- Please keep us posted
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Post by Sarah & Harper on Sept 20, 2024 19:58:05 GMT -7
Yes, 5mg of Pepcid 2 x a day.
She usually listens if I say sit but she does have a lot of energy and will kind of hold it all in and then bounce up and I have to say sit again and it starts all over again.
Again, she’s always had lots of energy. I will ask my vet about the sedative. For the few hours after I give her gab, it does seem to sedate her… it’s more like after hour 4 that she gets a little wild, then she does calm down on her own (she is almost 12 after all).
Wondering if cbd would be good to give her?
Also wondering if 5 day of pred is enough as I know you guys say 7-30 days. I asked my vet multiple times for 7 days and she keeps saying no. She says this is how they prescribe. But again, she wasn’t even keen on giving me this Rx as when she saw Harper after 2 weeks, she said Harper didn’t seem to be in pain, but had neurological defects - ie wobbly walks and crossing paws. It was only after I came here to discuss PT and you guys said if her back is hunched she should go back on the pred and I demanded, that my vet finally relented to the 5 days. Should I try to get them to give 7 days again?
Harper’s back is still hunched but she shows no signs of pain that I can see.
I can still give the gabapentin 3 x today if you think best, but one time yest when I tried to give in her mouth she snapped at me. My dog has never snapped at me in the almost 12 years I’ve had her. Never snapped at anyone. She seems super angry that I was putting it in her mouth so I decided best to only do it twice a day with her food… also considering I am not able to see any visual signs of pain.
No difficulty getting up, no shivering, no yelping, let’s me pet her, rolls over to her side to let me tickle her tummy … her walk is still a bit wobbly but she also is isolated from moving. She hasn’t knuckled her paw in a few weeks… she does still cross hind legs occasionally but they more seem stiff when she walks. Sometimes they splay when she stands. Is this pain or is this neurological?
I know arched back means pain from what you said to me from day one, but honestly that hasn’t gone away at all… not with gab or pred — and maybe it’s more sore muscle? I read it can be a muscle thing after an ivdd episode. Any thoughts?
Thank you
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 21, 2024 8:37:36 GMT -7
Sarah, because there were suspicious signs and because the anti-inflammatory treatment was not done in the usual manner (stopping both pain med and pred at the same time), there was not proof that all painful swelling was gone. This is the reason another course of pred is being tried to get to the bottom of whether there is still pain or no pain at all going on. -- Do not make any more changes to gabapentin today, 9/21. Stay with with the 2x/day dosing in her food. -- Do not jump the gun wondering about a longer pred course. Wait til the final pred taper dose is given. 9/22 starts the Pred taper and the stop of gabapentin. Only the final dose of the pred taper will provide the truth about pain. -- On the final pred taper dose, if pain should surface, THEN you have proof if another pred course is needed. No vet knows how many days a course should be. All vets must guess. Many vets choose a 5 or a 7-day course and then watch the taper to see what happens. -- During the pred taper that starts Sun 9/22 and with no gabapentin used, you will be watching for any sign of pain surfacing or any new or increased nerve damage. To help you verify pain, often it helps to confirm pain if you observe 2 or more signs of pain. Some things that look like pain, may not be pain. SIGNS OF PAIN: ⚙︎ shivering-trembling (cold or pain)
⚙︎ yelping when picked up or moved (anticipated pain or real pain) ⚙︎ 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 around them MONITORING NEURO FUNCTIONS
during the course of the 9/22 pred taper for new or increased nerve damage from the baseline of what you observe 9/21
There could be a predictable stepwise surfacing of new or increased nerve damage that can be revealed with the tapering of pred and no pain meds on board.
Typically one might see new or increased nerve damage if, IF there has been excessive movement during the period of strict crate rest necessary to heal the disc.
1. Pain with initial tear of disc and ensuing swelling
2. __Wobbly walking existing on 9/20
__legs cross existing on 9/20
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
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Post by Sarah & Harper on Sept 23, 2024 20:37:38 GMT -7
Harper update [9/23]: today is day 2 of NO gab and only 2.5 of pred. So far I don’t see any visual signs of pain.
Harper had so much energy yesterday and was whining to get out of crate for the majority of the day. She calmed down at night. I put a white noise machine downstairs in the living room where she is sleeping (she usually sleeps in my room and I sleep with white noise so I thought this could help). Any other ideas besides meds to knock her out?
I’ve been giving Pepcid 2 x a day. Do I still do this even on the days she isn’t getting prednisone?
I have noticed that when I pick her up to take her to her puppy crate (for naps) or outside to poop, after I put the harness on her she does this thing where she tries to jump up - front paws fully off the ground. I have caught her every time and I say no, but how do I mitigate this behavior?
I think I mentioned she doesn’t love to be held, never has, I’m literally the only person that can pick her up… and she’ll usually run and hide so I can’t get her (obviously not able to do that since aug 19), and when I would finally get her she always jumped up into my arms when I picked her up, so this isn’t a new behavior, but one I’d obviously like to avoid while she is recovering.
I’m not sure that the arch in her back is fully gone - at times it’s more prominent than other times. When she does take a few steps for potty or to stand and eat food, she seems less wobbly, although back paws still cross every now and again. She definitely isn’t back to how she walked pre-flare-up, but not nearly as bad as she was aug 19-21.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 24, 2024 10:00:12 GMT -7
Sarah, sounds like so far with the pred taper and no gabapentin, things are good. The final proof if the painful swelling is gone, of course, comes with the final dose of pred. Use Pepcid AC right up until the date for the final last pred dose. You are reporting some nerve healing too: less wobbly legs. With time the crossing legs nerve damage can heal too. Yes, there is a need to retrain Harper about jumping into your arms for now during disc healing and for the rest of her life. Maybe have the leash already connected to the harness. Step on the leash to shorten its length that would not allow any jumping up ability. Then put the harness on Harper and you stand up still stepping on the shortened leash. Immediately command sit or lie down. Big praise and a teeny treat reward. Repeat several times and maybe several different times during the course of the day. This will take time to retrain her behavior. Consider some of these ideas to burn off some of that excess energy: Let her work for dinner -- 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 rambutious and calmly licking. www.amazon.com/s?k=lick+mat+for+dogs&crid=RO08LX3WJGGZ&sprefix=lick+ma%2Caps%2C302&ref=nb_sb_ss_ts-doa-p_1_7-- During the day try her crate on a sturdy coffee table or the on the dinning room table so there will be a view out a window and a better perspective on what is going on in the house from a high. And maybe better to see what is going on outdoors. Use a non-slip mat under the crate to prevent shifting on the smooth table top surface. As long as Harper would calmly use a kong it can provide a job during crate rest.... to eat dinner via a kibble meal frozen into a Kong. Licking and eating will now require more time & effort and it is stimulating. Be sure to subtract what's in the kong from his daily kibble allottment so as not to gain weight. What/how to stuff and training tips: Be aware in case you might be unintentionally training for undesirable behavior. Dogs see food, attention, eye contact, talking to them, approaching the crate, and petting as rewards. Therefore, whenever you notice undesirable behavior, try speaking to your dog in his language to get him to calm down. Until he calms down and settles, turn your body to the side and avoid making eye contact. Start teaching what you do want before there is too much practice in doing the unwanted behavior. Give your dog a reward of a loving, relaxed "good sit/lie" whenever they are sitting or lying quietly. Your dog will quickly realize that sitting quietly, etc. is rewarded. |
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Post by Sarah & Harper on Sept 24, 2024 13:35:24 GMT -7
Thank you. So to confirm, on the every other day of prednisone, I still give her the Pepcid even on the days that I am skipping prednisone?
I do do a lick mat and add unsweetened and unsalted carrot puree, yogurt, banana, green beans, and peanut butter (rotating ofc).
She licks it up in minutes and then bites on the mat to try to get every last morsel!
I will think of other things to keep her entertained. If anyone has any ideas, I’m all ears!
You don’t suggest taking her on a walk in the dog stroller outside, correct?
Thanks
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Post by Romy & Frankie on Sept 24, 2024 13:55:32 GMT -7
I am happy to hear that the taper is going well. When our dogs start feeling better, it is harder to keep them from moving too much. They think they are fine, but we pet parents know that they are still healing. Freezing the lick mat after you have put on whatever food you are using means that it will take longer to lick it all up. I had to do this with my dog, Frankie. Otherwise, he would gobble it up in about 30 seconds. It is best to continue the Pepcid AC every 12 hours even on the days when Harper is not taking any pred. Continue until she is no longer taking any pred. During the crate rest period, it is safest to use the stroller only indoors.
When my dog was on crate rest, I played the muffin tin game with him. I sat right outside the crate and put the tin inside near the door. Frankie was able to play this even lying down. I am not sure if you have had a chance to look at the muffin tin video here: dodgerslist.com/have-fun-nose-work/
As with any activity, if the dog becomes too excited and is at risk of moving too much, the game should be stopped. |
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Post by Sarah & Harper on Sept 25, 2024 13:31:52 GMT -7
So I have noticed today and yesterday that when I took Harper outside to pee and poop (do this only when she has to poop bc otherwise she will pee on a pee pad which is in her crate/ pen)…. Anyway last two days outside on the grass when she bends down to pee, she knuckles the left paw. Both times. Not when she walks. Not when she pees on the pee pad inside.
Should I be concerned? Should I just not let her out anymore at all and only do pee pad (she will eventually poop there even though she doesn’t love it).
She seems to dislike the grass and wants to go onto the sidewalk (concrete) when she is outside so wonder if this has something to do with the knuckling on the grass when she pees.
Thank you for your feedback.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 25, 2024 14:28:03 GMT -7
Alert the vet of ANY new or increased deterioration of nerve function asap from the baseline status you reported on 9/21. You did not report any knuckling existing on 9/21. So this knuckling is something new.
-- Be sure you fully report what you observe.
-- If the knuckling under of the paw happens only on grass and not on a floor surface, etc.
-- Use DATES not: Tuesday, last week, etc.
Is this what you see and are calling knuckling?
Dog knuckling under the paw due to nerve damage. MONITORING NEURO FUNCTIONSduring the course of the 9/22 pred taper for new or increased nerve damage from the baseline of what you observe 9/21 1. Pain with initial tear of disc and ensuing swelling2. __Wobbly walking existing on 9/20 __legs cross existing on 9/203. __Nails/toes scuffing floor4. 9/25-26 Paws knuckle under. Dog is slow to correct or can't right the paw(s) at all5. __Weak/little leg movement __can't move up into a stand6. __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 lost9. __Deep pain sensation, the last neuro function
NEW or increase nerve damage or pain signals the need another course of prednisone + pain meds
Keep us posted on meds Rx'd and what the vet says.
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Post by Sarah & Harper on Sept 25, 2024 14:37:05 GMT -7
09/24 - 09/25 - knuckled back left paw when bending down and peeing ONLY ON GRASS.
TBH I didn’t see if she had done it before then while peeing on grass. She was knuckling when she walked 08/19 until probably 09/12 and then it seemed to go away (it was definitely improving during that time with PT, which I know now I wasn’t supposed to do).
I was just so excited that she wasn’t knuckling when walking or doing it very rarely that I hadn’t checked when she peed. Both today and yesterday I noticed because I was wearing my distance glasses and could tell that her back left paw was under her. One of the PT exercises was to have her stand straight and support her backside while knuckling the paw and having her right it. I started PT on 09/09 and she was still knuckling sometimes when walking. By 09/14 after a week of the exercise, I didn’t see any knuckling.
Do you still think I need to ask the vet for more meds? The vet didn’t even want to give me this round of prednisone. I’m a little confused because in the past it seems that you say neuro takes longer to heal and that pred doesn’t help neuro.
Currently Harper is in no signs of noticeable pain.
Thank you in advance for clarifying.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Sept 25, 2024 19:28:11 GMT -7
Sarah, the only facts we have are what you report. We base our comments on your facts as the baseline for going into the pred taper.
At this point, it can only be you who will have to decide if there is new deterioration of left rear paw knuckling since 9/25-26 or this is the usual sporadic knuckling been going on since 9/12ish.
New knuckling means another course of prednisone. Tapering of prednisone (no longer working on swelling) revealed that swelling resurfaced and impacted back left paw neuro function.
If infrequent knuckling has been going on since 9/12 thru 9/21, then there is no increased neuro diminishment. And no need of another pred course. The body can take months to heal and repair damaged nerves.
Prednisone does not heal nor repair nerve damage. Pred's only job is to resolve painfully inflamed/swollen tissue around the cord.
Pred can ward off nerve damage by resolving the root cause of swelling around the spinal cord. Nerves do not like to be pressured with inflammed and swollen tissue pressing on them. Nerves start to die and is observed as increasing neuro function diminishment. That is why hours matter when you observe new decline of nerve function to get pred back on board.
It is your job at home to be the eyes and ears for your vet.... to report new or increased pain and ditto for neuro functions. So it is you who will have to reach into your brain to determine if left rear paw knuckling has increased in frequency. By tomorrow morning you should have observed enough to know if you need to report to your vet.
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Post by Sarah & Harper on Oct 4, 2024 15:48:35 GMT -7
Harper finished the taper 10/03 yesterday,, and isn’t exhibiting any noticeable signs of pain.
These past few days she has so much energy and is so whiny in her crate. As Marilyn mentioned about her dog Ricky, Harper tries to jump up. She’s also taken to a new behavior… humping my arm when I pet her or pick her up. She puts both of her front legs on my forearm, wrapped super tight, lifts her body so she is standing on her hind legs, and then begins to tense and hump. I obviously say no and sit every time but when I pick her up and she does it when I’m carrying her it’s difficult to make her stop. I did some online sleuthing and it could be anxiety, over excitement, or a UTI. I emailed my vet on Tuesday 10/01 and they suggested I bring her in to check for a uti and check her anal sacs. But Harper isn’t exhibiting any other signs of a UTI - no discolored or bloody urine, no bad smell, no overly licking, etc. so I opted not to go to the vet but I’d love any advice on what this is and how to get her to stop.
Thanks.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Oct 4, 2024 16:30:19 GMT -7
Sarah, very good taper finished and no signs of pain! All that remains is to complete the rest of the 8 weeks to allow the disc to heal... with a graduation day of Nov 11. Most UTIs will show a change in color, a different smell, reluctant to pee because it hurts, etc. But not always are there signs we can observe. Just something to keep in mind and monitor. Don't know the cause this humping just now starting. The humping thing is not good for a healing disc. Why do you need to pick her up if she is pee pad trained? Harness and leash her to allow a few minimal footsteps over to the pee pad? Use another crate or an 8-panel ex-pen placed at opening to her recovery suite. At potty time you move the ex-pen panels her suit door to allowher to take a few footsteps to potty on the pee pad in the ex-pen. Ditto if using a 2nd crate.  |
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Post by Sarah & Harper on Oct 4, 2024 16:35:41 GMT -7
Because she poops outside. I also move her from downstairs to upstairs. As I wrote prior, her pen is 48 by 24 so it contains a pee pad and a bed and water and food. That’s it.
And when I just pet her she grabs onto my arm and does it too.
I can go to the vet I just thought it would be worse to go to the vet if it’s not an emergency.
She has a ton of energy so I read it could also be a way to release energy/ overexcited.
Was just checking to see if you guys had any info on this or heard of something like this before. Maybe I just take her to the vet and have the doctor check it out…
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Oct 4, 2024 18:45:21 GMT -7
Having a UTI would be an emergency to get antibiotics on board IF she has a UTI.
Maybe you could to put some grass clippings on a pee pad indoors so you do not have to carry her out to poop. She is doing too much movement for the healing disc. You are best able to judge the action you should take to keep her healing disc safe.
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