Conservative Treatment Overview: 4 Phases of healing during a disc episode

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Medications do these things:
  1. Steroid or a NSAID reduces swelling in approx. 7-30 days
  2. Pain medications give comfort from the pain of inflammation in the spinal cord.
  3. Pepcid AC protects the stomach lining from the anti-inflammatory (steroid or a NSAID)
  4. Conservative vs. Surgery
  5. When to  consider surgery
How the disc damages the spinal cord video:
Time and the body heal these:
  1. Disc damage is repaired only by time and limited movement to allow scar tissue to form. 100% STRICT rest 24/7 for 8 weeks during conservative treatment.
  2. Nerves heal with time. Think in terms of months for nerves to regenerate enough to bring back bladder control and leg functions.
  3. Acupuncture or Laser Light therapies help stimulate tissue repair and can be started right away.
Illustration from Hill's Pet Nutrition, from the Atlas of Veterinary Clinical Anatomy.
The spinal cord is composed of
a bundle of nerves running from the brain to various parts of the body....legs, bladder, tail, etc.

True success with IVDD is measured by the most important goal of returning your dog to a pain free, happy and full-of-love quality of life after crate rest. Should paralysis occur, please know that dogs do not view the lack of ability to walk as a minus as humans do. Dogs adjust to what is and then get on with the business of fully enjoying all that life has to offer until nerves repair! Learn how to re-think things!

1. PAIN relief happens in approximately an hour with correct dose, frequency and combo of pain meds. Prompt phone feedback to the vet is essential in getting pain relief meds properly adjusted. full article...

A combo to address the 3 sources of pain. Rx'd for every 8 hrs for round the clock control:
                             •Tramadol- general pain relief Methocarbamol-muscle spasm pain                           •Gabapentin-nerve pain  •Amantadine an extra dimension of relief for severe pain

Signs of pain:
  • yelping
  • trembling or shaking
  • arched back
  • reluctance to move
  • tight/tense stomach
  • holding a leg up and not wanting to use it
  • dog's personality is not back...not interested in things
  • head held in an unusual position...head down or nose up high
  • panting 
Related information:
$4 generics used with IVDD
Surgery vs. Conservative
Dr Isaacs' answers on surgery
Board certified neuros & orthos
Drugs used for pain control
2. SWELLING reduction in the spinal cord may take anywhere from 7-30 days before it has been resolved.  full article...

Danger: Never give a NSAID with a steroid. 5-7 day washout needed with switches:
2.  Steroid to NSAID
3.  NSAID to steroid

Meds: There are two classes of drugs to bring down swelling in the spinal cord.

1. NSAID (non-steroid anti-inflammatory drug)
  • Rimadyl.
  • Metacam, and others
2. Steroids
  • Prednisone/Prednisolone,
  • Dexamethasone, and others
Stomach protection:
1. Pepcid AC (famotidine) suppresses stomach acids anti-inflamamtories cause in order to avoid bleeding ulcers.
Adverse signs needing prompt vet help:
• Not eating or drinking
• Vomiting or w/blood
• Diarrhea or w/blood

2.  Washout period of 5 to 7 days to protect the GI tract should there be a need to switch between NSAID brands or NSAID <--> steroid. For emergencies w/o a washout, sucralfate is added to Pepcid AC for double GI tract protection. 

Related information:
How to help with cervical disc
FDA: All about NSAIDs
NSAID package inserts
Relative steroid strengths
Steroid adverse side effects
3. DAMAGED DISCS take 8 weeks during conservative treatment to heal with 100% STRICT rest.  full article...

to heal a disc:  none

Movements to avoid with conservative treatment::
  • baths
  • sleeping with you
  • sitting on your lap
  • sniff fests at potty time
  • Chiropractic therapy
  • water therapy
  • eating outside the crate
  • dragging legs around
Note: post-op dogs under the direction of the surgeon can begin PT, water therapy soon after surgery. PT is always deliberate, purposeful and under control.  Post-op crate rest is usually for 6 weeks.

Related information:
Proper crate rest technique
Setup tips on recovery suites
Why no chiropractic therapy!

4. REGAINING NEUROLOGICAL FUNCTION has no time limit. full article...

to heal nerves: none

  • Laser light therapy
  • Acupuncture
Acupuncture and Laser Therapy stimulate the cell's metabolism that leads to the body's natural repair abilities and can be started as soon as possible

NOTE: Laser light therapy is contraindicated with tumors.

During conservative treatment, anytime out of the recovery suite is a dangerous time for the early healing disc. Movement of the back/neck can increase a disc tear and escape of disc material into the spinal cord . For an animal with no or very mild neuro deficits, the risk of transporting to therapy has to be carefully weighed against what benefit is to be gained.

Related information:
Success stories
Laser Therapy heals nerves
Find acupuncture/laser light vet