Cera's LittleFoot 10/5 conservative

Hi Cera, welcome to Dodgerslist.. So sorry to hear that you and your dear LittleFoot are having such a rough time. Just to clarify you mentioned he was sent home with Tremodyl..  Not sure if you meant Tramadol or Rimadyl?  Tramadol is a general pain reliever that is commonly used with IVDD.    Rimadyl is a NSAID and absolutely should NOT be used while LittleFOOT is on Prednisone.. Very dangerous to her GI tract.  Stop giving it if that is the case and stick with the Prednisone.   If it's Tramadol, that is very okay.

NOTE: FDA and manufacturer package inserts warn against use of a NSAID with a steroid or with another NSAID without a washout period of 4 to 7 days before starting the new medication. Vets that practice safe medicine require a 4- to 7-day washout period between the medications.

When using either a steroid or NSAID, an acid reducer such as Pepcid AC is necessary. Dodgerslist follows those vets who are proactive in protecting the stomach, choosing not to wait until a bleeding ulcer or life-threatening stomach perforation happens. Ask your vet this way: is there any medical reason why LittleFoot can't take Pepcid AC to protect her stomach?"

These are serious signs of GI tract problems which can quickly move to a life threatening situation, get with your vet ASAP about a 2nd stomach protector, Sucralfate, in addition to Pepcid AC (famotidine):
Not eating, vomiting, loose stools, diarrhea, red or black blood in stools..

Constipation isn't unusual considering the medications.. Pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. To firm up the stool add 1 teaspoon pumpkin to kibble and no extra water 1x a day. Note alternatives: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potato.

Sending prayers your way..

I'm not one of our wonderful moderators who have tons of information, just another "mom" watching her "baby" falter.  Just sending you tons of support and hugs...this is a rough road.  PS...I totally get the financial restrictions...so do many here.  We do the best we can for them with what we have and lots of love.

Jean

Dear Cera,

If LittleFoot has lost deep pain sensation, then there is a window of time where surgery can still be successful. That window of time is 12-24 hours from losing deep pain sensation (DPS). Even after that window of time, surgery is often successful. The spinal cord is very fragile, the more hours after the window, the less chance of a complete recovery.

Please don't feel guilty if you can't afford surgery. There is still hope that DPS will return with conservative care. But you must be diligent in keeping crate rest 100% strict 24/7. In that regard, your vet is incorrect in advising you to start three five-minute sling walks. The purpose of crate rest is to limit movement of the spine as much as possible. The crate acts as a cast for the back. He is only to be carried in and out to potty or to the vet. When doing potty, his steps should be limited to a very few. And your vet is also incorrect in advising you to give LittleFoot a bath every day. Any time out of the crate is a dangerous time for a dog with IVDD. Wet dogs are very slippery and a slip and fall is not something you want for LittleFoot.

Once LittleFoot is off all medication and has no pain, the very, very lightest least aggressive range of motion and leg massage is necessary for paralyzed or weak legs during conservative treatment. The information highlighted in PINK pertains to a dog who can't walk. www.dodgerslist.com/literature/massagepassiveexercises.htm

My prayers are with you.

Dear Cera, I wish I could tell you what LittleFoot's chance are but no one, not even a Board-certified neurologist or surgeon, can tell you what type of recovery LittleFoot will have, though they may throw a number at you. I do know that it takes 8 weeks for the disc to heal and for scar tissue to form over the disc. As for regaining feeling, that means nerve regeneration and that can take weeks, months, even years. And, of course, sometimes the nerves do not regenerate. If you can afford it, you might want to look into acupuncture or laser light therapy. That can be helpful in giving the nerves a jump start and can be started while on crate rest. www.dodgerslist.com/literature/healingacupuncture.htm

One important thing I do want to point out to you is that usually Prednisone is given at the anti-inflammatory level (5 mg 2xday) for one or two weeks before trying a taper.  Your vet has prescribed only a few days on the anti-inflammatory before tapering.  You'll need to be on a close look-out for any signs of pain.  If there are signs of pain, that means that more time on the Prednisone will be needed and you'll need to notify your vet.

Warm water is not going to heal the disc or regenerate the nerves. Only restriction of movement will heal the disc and only time will heal the nerves. At this point, there may still be swelling around the spine. The swelling is pressing against the spine and that is what causes pain and nerve damage. Until that swelling is gone, you don't want to do any type of therapy or massage.  Once the medications have been tapered and there are no signs of pain, then the exercises in the link I gave you before can be started, but only then and only the passive exercises.

I'm glad you agree about the "walks". Limited movement is what will heal his back. Don't be concerned about his bowel movements. He may not have the sensation to push but reflex will work to get the poop out. You can learn to express for poop, too, which will help with accidents. www.dodgerslist.com/literature/Expressing.htm

Yes, vets can be extremely expensive. I have certainly learned that the past two years. We can only do the best we can do. There are no guarantees with surgery, as there are no guarantees with conservative care. And there are risks involved with surgery. So please don't feel any guilt. You're being a very good advocate on behalf of LittleFoot and are to be commended for getting him the care he needs and for looking further for more information.

Blessings to you both.

Marjorie has used the green tea to clean up urine from the fur and skin. The green tea neutralizes the urine and the smell too
My Stevie had laser and accupuncture and benefitted greatly - it's a really nice adjunct to conservative treatment if available and affordable ( some places are ridiculously high)

Cera, the yelp is showing that there is still inflammation in the spinal cord that Pred needs to continue to work on.  So it is clearly not time to start the taper of Prednisone today, 10/8.  Your vet needs to know about the yelp so that LIttleFoot can stay on the original dose of Pred.

Often it takes being at the anti-inflammatory dose of prednisone (5mg 2x/day) for 1-2 weeks or even for some dogs more like a month before all the swelling is gone. When the vet guesses swelling might be gone there will be a call for a taper. The dose is lowered to less than the anti-flammatory dose your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. To have a clear picture on a taper, pain meds are also stopped or backed off too.

Rule of thumb is:
pain = swelling = more time on Pred needed.

--Can you tell us specifically how many mg's of Pred 1/2 tablet is?  Tablets can come in several mg sizes.
--Can you tell us specifically how many mgs of Pepcid Ac he is getting.  It should be 5mg of Pepcid AC (famotidine) 30 mins before pred and thereafter every 12 hours.  Pred should be giving with a meal for additional stomach protection.
--Your vet has plenty of room to move with Tramadol.  12.5mg's (1/4 tablet) is a very low dose for a 14 lbs dog.  The goal is 100% pain control dose to dose of the pain meds (tramadol and methocarbamol).
It is alright for LIttleFoot to sit on his butt  to change positions as long as he is not doing the rambuctious sitting up on his hind legs, trying to jump on the sides of the crate. 

Let us know what your vet says this am, when you report your observations.

Can you discuss with your employer of your quandry, work out with your employer to possibly come home at lunch, stagger your work day so there would then be over lap with your hubby's and your son's to give more coverage.

Please call into your vet asap, about getting sucralfate on board today. It is an Rx item they can call into your local pharmacy. Not eating is a sign of pred problems that needs to be nipped in the bud before it gets deadly serious. Continue to give Pepcid AC 2x a day 5mg's 30 mins before pred. And give pred with a meal for further stomach protection. Do your homework as usual for all your dog's meds: www.marvistavet.com/html/sucralfate.html

Get him out of the crate in this way. Keep a towel under him, better would be a fleece sheet. As synthetic fleece dries quickly and wicks moisture away from the body. More details on cutting up fleece as a bottom sheet under " Blankets and change of bedding" www.dodgerslist.com/literature/cratesupplies.htm. So back to how to get him safley out of the crate. Put a fleece blanket under him. When time for potty pull the fleece sheet towards the door of the crate where you will be better able to pick him up carefully supporting both ends.

You might also want to convert your crate to a top opening one as mentioned in the Crate Supplies article: www.dodgerslist.com/literature/cratesupplies/cratetopconvert.pdf

Note alternatives to pumpkin: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potoato. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. To firm up the stool add 1 teaspoon pumpkin to kibble and no extra water 1x a day.

At potty time the towel is way too much coverage on the penis. Use an ace bandage, a belt, a winter scarf OR better yet for male dogs is the figure 8 sling. How to make one with two leashes: www.dodgerslist.com/literature/cratesupplies/Figure8.jpg At potty time the sling is not supposed to be pressing on the bladder. That pressure is just like expressing so hard to tell if he can pee on his own then. If he IS sniffing and then peeing when he finds the right spot…that would be bladder control. Let us know the details on his pottying.

Keep us posted on what the vet says today about the yelp of pain and getting back on the the original dose of Pred a bit longer.

What about the Prednisone, Cera? Did the vet put LittleFoot back on the original dose due to the sign of pain you saw during the taper? The taper of the Prednisone is to test for signs of pain to see if the swelling is down. Pain = swelling = more time on steroid. Obviously, the vet agreed that there was pain since she increased the dose of the Tramadol. Please let us know what she said about the Prednisone.

I'm very glad that you're starting the laser treatments - they can be very helpful.

Are you expressing LittleFoot's bladder? Or he releasing urine on his own when you take him outside? Usually when they don't have bladder control, they don't know when they have to go. This is the position for using a sling:



Hope you see a poop soon!  Let us know what's happening with the Prednisone.

Why tempt side effects of stomach pain, diarrhea, or cramping with Colace when pumpkin does not carry any of these, is nutritious and does help if you believe the stools are a bit too firm. Note alternatives: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potoato. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day.

If you have not seen LIttleFoot sniff and then pee, he likel does not have bladder control.  Leaking on you when ifted is another sign of lack of bladder control and the necessity to go in and get a  hands on expressing lesson first thing in the am....this is a health issue to be prompt with.  Let us know what you observe.. if he has bladder control OR that you got an expressing lesson.

The pet strolleris a very good idea to keep him with you as you move about the house.  Do know all the caveats of using a stroller....check out this information: www.dodgerslist.com/literature/strollers.htm

If you are seeing signs of pain, it is clearly not time to be on a taper of  Pred at 1/2 pred (2.5mg) 1x a day.  There is not sufficient steroid to help to deal with inflammation still existing in the spinal cord.  He needs to be back on an anti-inflammatory level of Pred (5mg 2x a day).  It is important to speedily address this issue and get help for LIttleFoot since you said he did yelp in pain.

Update,..
I never had a chance to give any meds to him for constipation, the other night when he went for his last walk, Tim brought him in and he passed 2 little poops. They were solid. He plain outright does NOT like Pumpkin nor sweet potatoes.
However, I decided to wait on the Colace. and while Little man does not like pumpkin, I got a taste of it down him this morning.
By noon, flood gates opened and he went. However, he passed more this evening as well as a bit ago, and now it is straight out runny. Sigh.. Did I mention stinky?

But tonight also was the first night he ate everything on his dish, however, he is not eating his regular food, so I may pick up a bag of blue buffalo and see if I can entice him on something drier, and in the end, better for him.

The vet said 1 1/2 tab of pain med am, 1/4 afternoon 1/4 pm. I knew right off I would cut the am does back to be able to better spread that out for coverage. It took a bit out of him tonight on this last outing, only because he pood more, and as I supported him, and was wipling his bottom..

and I KNOW it is too soon, He lifted that tail up as I cleaned hm, I stopped in shock, he lowered it a bit, when I praised him, it went BACK up a bit and wagged. Tim took him out and he lifted the tail again, and did pee and poo..and wagged the tail.
I never been so happy..lol But I know it is way too soon.

He leaks, mainly when he is asleep, but when awake, he tells us he want out. I noticed him sniffing the ground now also. And he did so again on his last walk.

I will be calling the vet however to set up Laser Therapy, Looks like that will start Friday.

But pain wise, he is doing way better, as I said, tonight was a bit more because we cleaned him, and I think it was more of an upset tummy, because as I held him to wipe him, he let out gas, and then more poo..So Now I think I went from constipation to this, and will look on how to firm it up for him
He is highly alert, and now has a voice again..well, sometimes. lol But I need to settle the gas issue. I also noticed I was lightly messing with one leg, and he stopped and looked down at it and me.

All I know is we have a ways to go, but it gives me hope. AND a Kind lady is giving me a stroller, brand new. Don't get me wrong, I AM realistic..but hope is hope, and after the day I had, I'll take hope when I can get it.
Off to look up suggestions on diarrhea, all else fails, I'll be speaking to the clinic tomorrow anyways.

Off I go, I have a busy day tomorrow.. seeing my husbands car just decided to finally die due to a transmission..I have to be up early to deal with work and the car..ugh.
But his tail WAGGED! More then once!

Paulina,
I called the vet this morning, and left a message. But I have an appt this afternoon to start Laser Therapy.
I have a few concerns anyways, while I do not believe he has full bladder control, he knows when he has to go outside,
As for the food, he never was on a constant food, he had his normal kibble, but he has always ate..(I know..I have a grandmother here.. lol) people food, and has a cast iron stomach. Which is why I am thinking a different kibble..I know years ago when I was sick, normal things I ate, I had zero interest in. I noticed that with him, things he use to turn a nose up, interest him now.

And reality is, I'd rather have him eat, so I am pretty sure this is a med related issue, and as of this morning when my husband took him out (No accidents over night, and tail lifted again to poo) , his stool was beginning to clump again. Last night was the first time he ate as much as he usually does since Friday.

But I am pretty sure Dr T will be sending me home with another med for his tummy now. I am beginning to look like a pharmacy again..between my Mom's pup and LitleFoot..we can possibly open one now.

But I was wondering what food is good to help firm his stool up. And if I should..is Yogurt good? Cream cheese, cottage cheese?

I AM also going to have her show me this afternoon how to express his bladder..while he seems to know he needs to go out when he has to pee..I know helping him would be beneficial all around, and for his health.

Sorry this is all over the place.

Hi Cera,
It is never too soon to have hope, and I would have been cheering that tail wagging too, even if it woke up the neighbours. I hope that you both find that the laser treatment is beneficial, and the LittleFoot keeps on making progress

As I sit here and write this..I am in between despair and hope..and out right mental exhaustion.
So where do I start...
Thursday was suppose to be LittleFoots first day of laser Therapy. He was alert, perky, and my mom came over, he was excited to see her.
He still had diarrhea, so I cleaned him up. I then gave him a pill, which went down the wrong damn way..he started choking, No fault of his own, my finger was scraped, so between blood all over, him foaming, I tossed a shirt over him, my mom grabbed my stuff and I flew to the Vets.
By the time we got there, he was sitting on my mom's lap, ok..(I am only 10 minutes away) They checked him to see if he was alright, they got water down him ok..The Dr listened to his lungs.
I should have STOPPED right then and there..
But I asked about expressing, which she did, and showed me..(Still haven't mastered that) I also told her about his tummy, his refusel to eat and his refusal to take the pills..and I asked about that stuff. I am familiar with Carafate, Sassy had it a few times when she was alive. The Dr asked me if I wanted pill form or liquid. I chose liquid..he has enough pills.

She went ahead and gave him a dose. By this time it was 2:30, My mom had left groceries in their car, and I asked the Vet if I should just reschedule till morning. The appt was for 3:30. She said she could still do the treatment, and seeing I had to get my mom back, I left him there, knowing BY 3:30 he would be ready to come home..or she would have waited until I got there so I could see how they did the treatment.
But I figured why wait, and I'd be there for all the other times.

My Mom's car however, broke down, so I had to get them home..run back, get my gramma, and then go for littleman. he did a lot of sleeping. I did not get any pills down him except a Pepcid and a 1'4 tramadol.

he threw up that night. Friday, I called the vets again, and she asked if I could administer [nausea]  shots..I use to. She prescribed 3 doses One per day.. for nausea. I use to give shots, and she made the mention it could sting. OMFG..she was NOT kidding..even asking God for strength did not give me courage to mess with it again. He did eat Friday morning.. as ODD as this sounds, he was licking my finger, (The one that was bitten) And it hit me..he ate canned food for upset tummy and an egg..

But by last night.. he wanted no part of food again, not real food. Sigh..
So today, Saturday, he had an appt for Laser.. he did not eat, but his bowel movement was brown, and I noted two clumps, as if it were forming [poop].

So we went in and she did the Laser treatment, I had brought the shot with me, packed in ice, seeing it is suppose to be kept cold to begin with.. But OMG, did he yelp..
Screw the other 2 doses..I will NOT do that to him.

We got home, and he slept for awhile..However.. His poop is a runny green now,..the Vet closed before I could call them back. So I called the Animal Hospital. Ugh..
He IS drinking water. And he was awake earlier, but all he is doing tonight is sleeping, when he is awake, I know the little guy has to be in discomfort, but no real classic signs of pain or severe pain.

Did I mention he has relexes in both back legs? His tail still lifts halfway, and last night he was wagging the heck out of it??

But as of right now..Im been between despair, depression..and out right exhaustion.
My vet said No Pupperoni, No Liver Cheese..and no this, no that..but OMG, if this dog EATS I do not care as long as he does EAT..and what he may eat now, he will not touch later at all. I can not place a thing in his mouth, he sounds like a duck, acts like he is choking and drools salvia and foams..YET, My Fibber McGee here ATE broken hard treats and an egg, and canned food just fine yesterday morning.

And did I mention my other dog now has diarrhea, which she NEVER has?
I am at the point this guy needs full rest of ANY damn medication, until it is out of his system, and I start slowly over and figure out what is causing what.

My last dog could not tolerate prednisone..she was suppose to have a full pill, all I was able to give her was a 1/4..had she had the full dose, she may have lived a bit longer.

I am rambiling at all of this..but I have yet to even get my paperwork in order, seeing I am unemployed. trying to handle Littleman, and all of the other things..
Last night was the first night I had a full nights sleep, we have a mattress we needed to throw away, seeing we got a newer one, I've yet to see my bedroom in a week. So we tossed the mattress on the floor and lttlemans cage is next to it in the frontroom at night.

But his green diarheaa spooks me.. I know the animal hospital is open. and I very well may end up there tomorrow. For now, he is sleeping peacefully. and oddly..before all the stuff happened on Thursday, while he wasn't eating the best, nor taking his meds the best..littleman acted in no pan, was perky and laert and ..well..his tail wags and he has relexes in both legs.

I am a mental basket.. and all I can do is lie next to him, he rests his head on my arm, and all I can do is whisper to him..and fall asleep on the kitchen floor like I did Thursday night with his head on my shoulder. Good thing I am little to fit in that cage partially.. lol

Update.. Little guy woke up, and woke up starving, I had made a dish earlier for him of rice and turkey. I could not hand It fast enough to him, he ate the bulk of it. I am staying away from beef, which is what my vet said also. Which rules out his normal dry dog food right now.. BUT his stool went back to brown. The Vets at the hospital said it was more then likely his body getting rid of the bile..etc..

The shot she gave him was cerenia?? All I know is when she said it would sting, she meant it, he yelped like heck.

He has not been on any normal meds for the last few days.
Thursday he had his Pepcid, his pain pill and muscle relaxer in the AM
Thursday afternoon, he had a 1/4 pain pill, he choked on the muscle relaxer and we got him to the vets, she gave him the Carafate, in liquid..and she gave him the max dose at that point, and sent me home with a bottle..which is 5cc's 2 times a day..2 hours before any other meds, OR 1 hour after his meds.
Thursday night, I was able to get 1/4 of his pain killer in him.

Friday..
about zilch..

Saturday.. 5cc's this morning of Carafate, went to the vets, she gave the shot of cerenia.
And that is all I been able to give him. He slept most of the day after we got home, other then to go out.

I never gave the Colace..at all. I did give him a taste of pumpkin that Wednesday morning, by noon, it started a darn flood gate I been fighting since. Baby wipes, puppy pads, a box of detergent and loads, and loads of laundry...

My back is shot from walmart.. and I did not intentionally fall asleep..that was just how exhausted I was..and honestly, he is not the type to run off when he has a willing body to be next to. Littleman always was a snuggler. Last night was the first night we got more then 4 hours of sleep, and on a mattress..(Albit on a floor..but a real mattress! ) lol

It is now a quarter after midnight, littleman is fed, clean, dry..his cage next to "Our bed", and sound asleep.

I am hopeful tomorrow will be better, and I can get the Carafate in him, a Pepcid, and his pain pill at the least.if there is one thing about him, he is a fighter, and feisty, and determined. But I AM hopeful..I am noticing he is sniffing the outside when we go out, his tail wags more..not all the time or full force, but wags it does, he has knee relexes, and if I touch his back, lower part, he turns and looks.

I know how quickly it can turn back..but I am still praying..as is my friends. AND I have a BRAND NEW stroller I need to pick up, some lady is giving me, I can not thank her enough for this gift.
And thank yous for letting me ramble..


10:27 am...
he had a dose of carafate, and I got a pepcid down him..he did eat more Turkey and Rice, but I tried his pain med..Lol..Nope, no disguising that sucker, even crushed in water, he spits it out and acts like Donald Duck again.
I have tried numerous methods on disguising the pills, all to no avail, seeing he is not interested in a lot of the foods, and I am wasting more meds trying.

His poop is more yellowish brown, still runny.. and he is peeing..and right now, after he figured the water dish was safe, again..(Tried the meds with a syringe also..) he drank more water, gave me a look and is asleep.

I swear I will need to take stock in hair dye after this.