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Post by Pauliana on Feb 10, 2014 23:46:01 GMT -7
Posted for Member: Sturgess dodgerslist.boards.net/user/1736Hi , my 5 yr old Dachsie started having issues with his back, he is normal weight for his size 17.8 lbs, no stairs or jumping off of furniture. Any way he went into vet last Wed, walking like a old man back tense. xrays were questionable able a spinal compression,, His temperature was HIGH at 103.9. He was put on CLAVAMOX 2 times a day and Deramaxx once a day He is carried out side and put down to go pee and poop has not had any problem doing either he walks maybe 5 - 15 feet total and then is picked up and is put on his bed to rest. I work from home and he is by my side and does not stray so a virtual crate rest. His walking is slow like a old man gingerly. today was his best day he was very much more alive . He will stay on rest for at least 6 weeks NO AND IF OR BUTTS> I am quite anal about that , no matter how he feels of thinks he is doing. I have tried a few times to search about Temperature and Hypothermia. Marley has been RUNNING high Temps, 103, / 103 .5 / 103 .8. He is eating normal, drinking normal and eliminating normal. But his temps are SCARY. He is a long Hair. Any input on how I can research a HIGH TEMPERATURE ? He some times shivers / shakes but when he is cold he curls up in a ball to stay warm,, Today when he woke up at 8am his temp was 101 then at 11 am was 101.3 then at 3pm was 103.3 then tonight was 101.3 at 11pm after I turned on the ceiling fan and lowered house temp to 61 from 68 degrees. and made sure he could not be covered by a blanky. Any search items I can read would be helpful. He did get a full blood panel done when at the vets for his back last week and everything was normal. Thank you John |
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Post by Pauliana on Feb 11, 2014 0:04:34 GMT -7
Welcome to Dodgerslist John!
So sorry to hear about Marley's fever and disc episode.. Was he diagnosed with IVDD? Did the Vet tell you what was causing the fever?
Does he show he is in severe pain? Any breathing difficulty? Sudden twitching or jerking of the neck and/or head * loss of voice, hoarse bark * can't hold body up, can't hold head up?
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Post by John & Marley on Feb 11, 2014 11:05:28 GMT -7
Marley a 6 yr old 18 lb Long Hair dachshunds has had Back pain for 6 days now, he went to the Vet a Week ago Wed. He can walk , but gingerly, so he is on crate rest- STRICK, gets carried out to the back yard to do biz where he may walk 10 - 20 steps then carried. The same for eating he gets put in front of his bowl he eats then walks 10 steps to drink, ( his routine otherwise he wont drink water ) and drinking water is key when on Meds.
His visit at Vets was hard to show where exactly spinal issue may be located but we think its in one area with not much compression. Did a full blood work up, everything is fine. His temperature at the Vets were 103.6 and 102.9 The Vet felt a infection reaction to the back pain and back issues and prescribed CLAVAMOX for Infection- ( 2 X's a day )+ DERAMAXX for pain ( 1 X a day ) both with food.
His Diet is Raw Premade food, with Fish oil added, Ester C added and Probiotics added to each meal twice a day. He eats and drinks like always loves his food and water. His Pooping is normal and Peeing is normal , no issues.
His issues is that his Temperature can get quite high . The antibiotics were to help with that which he is on day # 6 of now and has 2 CLAVAMOX left , tonight's dinner and Wed Morning Meal and 2 DERAMAXX pills left , one for tonight and one for Wed Nights Meal.
He does shake some times, usually after a meal or pooping / peeing - I figure do to being on his feet and it usually subsides in 20 minutes.
I will be calling the Vets about his Temperature situation that has been going back + forth for 5 days 101 to 103.6.
My question is ? can he be switched to other Meds by the Vet from the CLAVAMOX + DERAMAXX to try to deal with the Infection causing the Fever / High temperature. BUT How much time do I have to wait between changing meds ? is it only for a Pain pill like Deramaxx or for antibiotics as well is there a flushing cleansing time period. ?
I know it is some where in the forum and I am looking but I can take hours researching reading and rehashing things, so some feed back would be appreciated. I do not want to call the Vet and be told something that may be problematic with out knowing whats can be a problem before hand. Also today a snow storm is hitting the south and may be snowed in on Wed and he may not be able to get to a VET.
Thanks a head of time
John
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Post by Pauliana on Feb 11, 2014 12:16:24 GMT -7
Hi John, Marley is shaking because not only the fever but also due to Pain... He should be on a pain reliever such as Tramadol... Disc episodes are extremely painful.. Deramaxx is dealing with the swelling that accompanies a disc episode and once the swelling is gone, so will the pain.. but that can take from two weeks to a month and in the meantime Marley needs comfort from pain.. Has he been diagnosed with IVDD? www.dodgerslist.com/literature/healingpain.htm www.dodgerslist.com/literature.htmSomething to keep in mind about Deramaxx. It isn't a true pain reliever it is an anti inflammatory and here is some information about it: "What is the most important information I should know about Deramaxx: Deramaxx is a prescription medication that is FDA approved for use in dogs. Deramaxx is available as 25mg, 75mg, and 100mg chewable, scored tablets. Contact your veterinarian if your pet has hives or an allergic reaction after taking sulfa-based medications such as SMZ/TMP, aspirin, or another NSAID such as Rimadyl. Notify your veterinarian immediately if your pet develops or experiences any of the following: abdominal pain, tenderness or discomfort, nausea, bloody, black, or tarry stools, water retention, fatigue or lethargy, a skin rash, itching, yellowing of the eyes, or unusual bruising or bleeding as these symptoms could be early signs of dangerous side effects. Before giving your pet any prescription or over-the-counter medications, check with your veterinarian or pharmacist. " It is very important to make sure Marley's stomach is protected from Deramaxx.. Ask your vet in this particular way: Is there any medical or health reason why Marley can't take Pepcid AC to protect his stomach? We follow vet's that are proactive in protecting our dog's stomachs to prevent stomach ulcers or a perforated stomach.. IVDD is more than enough to deal with, without a life threatening stomach bleed.. If there is no health reason then buy Pepcid AC from the grocery or drug store in the 10mg and cut it in half and give a 1/2 tablet to Marley 30 minutes before the Deramaxx and again 12 hours later and give with food as you have been doing. www.dodgerslist.com/literature/healingsweling.htmHas Marley had his urine tested for a Urinary tract infection? If not I would discuss that with the vet as well.. The vet needs to rule out all causes of infection/fever.. We have expertise in only IVDD/disc disease but can tell you it is common to have Urinary tract infections with IVDD.. other causes of fever aren't within our experience.. so lots communication with your vet to get to the bottom of it.. Does Marley show he is in severe pain? Any breathing difficulty? Fever, sudden twitching or jerking of the neck and/or head * loss of voice, hoarse bark * can't hold body up, can't hold head up? This would be symptoms of Myelomalacia that sometimes happens as a result of disc injury.. I pray it isn't this.. don't want to scare you but be aware.. www.dodgerslist.com/literature/Myelomalacia.pdf Clavamox doesn't need to be tapered.. Deramaxx would have to be washed out for 4-7 days only if changing to a Steroid.. Prayers for Marley... |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Feb 11, 2014 16:51:25 GMT -7
John, this temperature not reducing is of great concern that it has been going on for 5 days. So your vet is thinking there is infection going on in the spinal cord area? If the antiboitic was a match for the bacteria there should already be some relief. I would discuss with the vet if another antibiotic can be found to be a better match for the problem bacteria. I would also be leery at this point in time moving from a NSAID (Deramaxx) to a steroid. Steroids suppress the immune systems not what you want with this infection going on. A switch between classes of anti-inflammatories would require a safety washout of 4-7 days. Because he has no neuro deficits just pain, another reason not to switch to a steroid. How do you take the temperature? Normal rectal temperature is 100.5 to 102.5 degrees Fahrenheit. Shaking after movement such as a meal or after potty IS a sign that meds are not right. Marley has NO pain med(s) on board. Why? Have you discussed the typical meds used for pain with the vet? Have you reported your observations of pain. Pain slows/hinders the whole healing process and needs to be promptly relieved. This is good background info before phoning your vet about Marley's suffering with movement pain syou are in position to strongly advocate for help. www.dodgerslist.com/literature/healingpain.htmWith a disc episode it is critical to reduce movement where possible. Meals are served inside the crate. At potty time you stand in one spot with 6ft leash, harness and sling if Marley is at all wobbly. He may take only a very, very few footsteps to get his business done. Dogs always do the unexpected. We must be one step ahead of them by providing a safe environment to heal in. Anytime out of the recovery suite is a most dangerous time for the spinal cord if that disc has another tear from too much movement.  This clip will help you to understand the gravity of too much movement: The things to deal with today are: 1. Getting pain fully in control with actual pain relieving drugs (such as Tramadol, methocarbamol) 2. Getting bowls set up inside his crate for water and meals. How to make your own easy bowl holder: www.dodgerslist.com/literature/cratesupplies/bowlHLDR.jpg3. Protecting Marley's GI tract from Deramaxx damage. Marley does not need nausea, bleeding uclers or a worse life threatening perforated stomach lining. Problems can happen without warning. Pepcid AC is what vet use who are proactive with stomach protection. 5mg Pepcid AC (famotidine) 30 mins before deramaxx and thereafter every 12 hours. I saw you asked on Baxter Boo's thread about finding laser therapy. Often holistic vets will offer both acupuncture and laser therapy, check the yellow pages. Look for a vet certified in pet acupuncture. ahvma.org/Widgets/FindVet.html [holistic vets] www.aava.org/php/aava_blog/aava-directory/ [AAVA (American Academy of Veterinary Acupuncture] www.ivas.org/ [IVAS (International Veterinary Acupuncture Society] We look forward to getting some good news on pain med Rx, Pepcid Ac on board, and bowl attachments to his recovery suite. |
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Post by John & Marley on Feb 12, 2014 8:22:21 GMT -7
Spoke with Vet about Temps, not concerned as long as eating, drinking and going potty normally, Did say if it stays High for extended period to get a cold damp cloth against his tummy and neck area to cool him down. Depending on the weather and roads , Would like to bring him in on Thursday to Vets.He ill be out of Meds then and we will have to decide if to continue with CLAVAMOX + DERAMAXX for another week to give it a full 2 weeks Like the article suggest.
2. SWELLING reduction in the spinal cord may take anywhere from 1-2 weeks before it has been resolved.
Marley only exhibits pain when he is taken out to potty or to eat when he stands up on his feet and takes a few steps, then for on average next 10 20 minutes he shake lightly. He does let out a quiet moan / sigh when he adjust himself while laying down.
SO Im not sure if wise to take him off the CLAVAMOX + DERAMAXX combination so we can flush out the DERAMAXX in 4 to 7 days and then put him on a Steroid. That would leave him off a anti inflammatory for a week till we can get him on something else.
Have people gone 2 weeks say on a Deramaxx and then flushed out (7 days)and went to a Steroid ?
Have to read up and think about it, it is snowing quite heavy now and wont let up till 24 hrs from now, so Gives me till Thursday afternoon to make sense of it. The Vet that looked at Marley only works there part time and the Vet ( owner of the practice said he if he saw Marley himself would have put him on a Steroid from the get go). Marley can stand on his own , can walk albeit GINGERLY but is in discomfort and cant do his normal and favorite thing which is to roll over on his back and wiggle & wiggle till you submit and give him kisses. Now he lays on his side and gets his front paws and chest over but cant his back legs, which we when we see him trying ask him to stop so he doesn't tweak it more. Thanks again for listening and the info you have shared.
John & Marley
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Post by John & Marley on Feb 12, 2014 8:40:47 GMT -7
there is infection going on in the spinal cord area?
== In another post I mentioned his thoughts and he felt it was a body's reaction to the stress and pain. Will pick his brain more now that you've given me a better education
another antibiotic can be found to be a better match for the problem bacteria.
==Very Valid POINT, another ? on my list to address.
Steroids suppress the immune systems not what you want with this infection going on. ==Great advice - you answered a question in another post of mine. TY Will not switch him to a steroid
How do you take the temperature? == Rectally
Shaking after movement such as a meal or after potty IS a sign that meds are not right. == Can not go today due to the snow storm and Vets Office Closing early so will HOPEFULLY be able to on Thursday and bring this to VETS attention and get it resolved
With a disc episode it is critical to reduce movement where possible. Meals are served inside the crate. At potty time you stand in one spot with 6ft leash ==Will limit his movement at potty time and be fed in his crate as well as water.
For Meds will have to wait till Thursday ( SNOW STORM CLOSED OFFICE ) when he goes in again. ie : pain meds ( Tramadol etc ) Pepcid AC will be done with last Deramaxx he has left.
THANK YOU
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Feb 12, 2014 10:40:13 GMT -7
I'm sorry to hear you have no way to get in touch with your vet. I hope with further improvements to limited movement, Marley will not be so painful. You might consider a rice sock to rest his head on or lean against. Fill a sock with 1-2 cups of dry rice. Knot the end. Microwave for 1-2 minutes. Test in crook of your arm for warm not hot temperature. Wrap in a towel so it's not too hot for the skin and place in crate. Let Marley snuggle against when you are present to supervise in case he has a desire to munch on the warm rice. Note: human heating pads can get too hot burning skin on an IVDD dog. Snuggle Safe is a commercial product that will keep warm the whole night. www.valleyvet.com/ct_detail.html?pgguid=E53AAF66-347A-4789-AFCC-5D6FA77ED8B6&item=30459&ccd=IFP003&utm_source=froogle&utm_medium=free&utm_content=30459 |
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Post by John & Marley on Feb 13, 2014 19:27:08 GMT -7
Well, we are hoping that the VEST office will open on Friday they were closed all day today.. So we will address why he wasn't put on any pain meds and decide which to give.
•Tramadol as the general pain reliever. It has a short half life of 1.7 hours and may need to be prescribed at a minimum of every 8 hours.
•Methocarbamol treats muscle spasms stemming from aggravated muscles due to nerve trauma related to the spinal cord inflammation.
We have given Tramadol to another dog many years ago. How do we and how does the Vet decide what is the criteria to give one over the other ? Methocarbamol versus Tramadol ?
Come Friday Afternoon which is the soonest Marley can see the Vet he will be 48 hrs ( days ) off of DERAMAXX. The Vet mentioned putting him on •Prednisone/Prednisolone, after a 4 - 7 day )flush time. One of our other dogs many years ago that was on V•Prednisone/Prednisolone, as well as Tramadol also.
Marley this week has raised his tail wagged it, Stood on his own when peeing and pooping and has sensation in his legs and paws, but is in pain ( shakes a lot )and very tender and can walk GINGERLY which we do not let happen now. SO we have to decide on the two pain drugs and then to put him on the steroid Prednisone.
We are going to another Vet to schedule a 6 treatment of Laser therapy hopefully starting on Sat or early next week the latest.
I work from home so he is under constant supervision. Again Thanks to all for the input and help
John
Like I mentioned Marley has been on DERAMAXX for 7 days and will be off then for 2 days before we can get a REFILL or opt to switch him to Prednisone/Prednisolone after waiting for 4 to 7 days. Has any one done a switch like that before > How did there dog fare and behave over the 4 to 7 day flush period ?
TY
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Feb 14, 2014 7:12:57 GMT -7
John, the reason for prescribing an anti-inflammatory (whether a steroid such as Predinsone or a NSAID such as Deramaxx) is to get the swelling down. The swelling is pressing on the nerves of Marley's spine and that is what causes the pain and can cause nerve damage. Being off of the Deramaxx for the last two days, Marley has had nothing to work on the swelling. To continue with more days without an anti-inflammatory to accommodate a wash-out period before switching to a steroid would be dangerous. He needs to get back on the Deramaxx today so I hope there is some way you'll be able to get the prescription refilled today. As Paula mentioned above, since Marley isn't showing neuro deficits, only pain, there should be no reason to switch to a steroid. Steroids are usually given when there are more severe neuro deficits. Also, as Paula mentioned, if there is an infection going on, you wouldn't want a steroid given as steroids suppress the immune system. As for pain meds, Tramadol is usually the pain med prescribed. Methocarbamol works on a different kind of pain - the pain caused by muscle spasms. Gabapentin may be added to the mix for hard to control pain and nerve pain. Veterinarians are finding this medication works very well in combination with Tramadol. It's important that you be knowledgeable about each medication being given and all cautions concerning them. www.dodgerslist.com/literature/drugs.htmmarvistavet.com/html/pharmacy_center.htmlDoes Marley still have a fever? Prayers that the vet will be open today or that you can get Marley to an ER vet ASAP. Please let us know how that works out today. |
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Post by John & Marley on Feb 14, 2014 7:58:28 GMT -7
Thanks so much for the info makes my decision more logical now. Have a apt. with the Vet at 11:30am to check him out and get more meds. THANKS
JOHN |
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Post by John & Marley on Feb 14, 2014 19:41:55 GMT -7
Well we had Marleys 11:30 Vet appointment , Did a New set of xrays, new blood work as well as UTI Test.
UTI Negative, blood work normal and xrays really did show a disk compression. On the drive down we thought how he was in such pain yesterday shaking and trembling and here it was a day later and nothing, not even in the Vets and we were there for 90 minutes. He was up since 730am and here it is Noon time and no shaking even while at the VETS with cats crying and dogs wimpering.
Its been 36 hrs since he has had a tab of Deramaxx and48 hrs since any CLAVAMOX and he isn't shaking, The list of side effects didn't show these as on the list, but it seemed interesting that after it had some time to get out of his system he isn't shaking, I felt his body was not tolerating those two drugs well. So we choose to go with the Vets suggestion and put him on
•Prednisone/Prednisolone, starting Mon after a 5 day flush out with
•Gabapentin as his pain Med. staring that this afternoon.
He also had his first Laser Treatment really seem to like it. He goes back in for Laser # 2 on Sat Morning and Laser # 3 on Monday Morning. His temperature today has been normal, no fever and the shaking he had on Thursday is gone. So it look like the meds he was on wasn't fitting with him . Time will tell..
We will keep you current on his status and progress and THANKS SO MUCH for your wealth of information and caring so much, will touch bas after his next laser treatment to comment on how he does.
John
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
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Post by Marjorie on Feb 15, 2014 7:20:54 GMT -7
Thanks for the update, John. Please be on the close lookout for any signs of pain (shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, nose held to the ground, head held up high, tight hard tummy, arched back) or signs of neuro deficits (wobbly walking, crossing of hind legs, loss of bladder control) during this wash-out period . Any signs of pain or neuro deficits will require an emergency call to the vet. If they are open today, please call and ask what you should do if you see signs of pain or neuro deficits over the weekend when they're closed. Swelling pressing on the nerves of the back can cause paralysis so it's vitally important that you have a back-up plan for when the vet is closed this weekend or if the weather turns bad.
If Marley's condition worsens during this wash-out period, the steroid may have to be started earlier. If that is the case, the vet can prescribe Sucralfate to double protect Marley's GI tract. I know you had given one Pepcid AC with the last dose of the Deramaxx. Please be sure to give 5 mg of Pepcid AC 30 minutes before the dose of the Pred when that starts and thereafter every 12 hours.
Please let us know the exact dosages in mgs and frequency given of the Gabapentin and the dosage and frequency of the Pred that will start on Monday.
Continued healing prayers for Marley.
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Post by John & Marley on Feb 15, 2014 22:12:29 GMT -7
Keeping fingers crossed till Monday, He went his morning for his 2nd Laser Treatment and has been good through out the day, he does show minor discomfort after eating , which last 5 minutes and he stops shaking, unlike earlier in the week where It last painfully longer watching, the SNOW STORM was not his friend everything was shut down from tues till Fri morn.
He has slept most of the day and been at ease unlike earlier in the week.
What is the best way to pick him up to carry him out side to pee? I have always picked him up one hand under his chest behind his front legs and 2nd hand right in front of his back legs behind his winky. Tonight he is shaking a bit after coming in the house, I did have a sling under his back end while he peed and picked him up after he stopped - no walking no steps. , |
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Post by John & Marley on Feb 15, 2014 22:19:17 GMT -7
What is the best way to lift and carry your dog to go potty.
Prior to his back issues I have always lifted Marley with two hands ALWAYS.
1st hand behind front legs under his chest. 2nd hand in front of back legs but behind his winky touching his back legs and when I lift his I hold him touching my body so he doesn't twist any .
Tonight , he is just came in from going potty just minutes ago and is shaking a lil bit, He took no steps and had a sling under him for support. So some how the way I held him or lifted him put him in pain.
So what is the best way to lift ? |
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Post by Pauliana on Feb 15, 2014 22:34:32 GMT -7
Hi John,
Here is a video that shows how to lift and carry Marley!
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Post by John & Marley on Feb 15, 2014 22:42:14 GMT -7
Marley is 17.5 lbs
Gabapentin at 50mg twice a day for 10 days
Prednisone 5mg -
1 Tablet twice a day for 5 days
1 tablet once a day for 5 days
1 tablet once a day every other day.
Is there a link for the video My windows 8 / IE 10 is not showing any thing
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Feb 15, 2014 23:04:51 GMT -7
John, I'm aghast at a switch, a washout without any appreciable compensation for expected pain when no anti-inflammtory would be on board and this happening over the weekend when he is not open to confer with. This vet never Rx'd ANY pain med right from the start, that is why the pain was never in control, he only Rx'd Deramaxx. Now he still gives no real pain relief, gabapentin alone would not likely fully control pain. Sorry, but I really want to say some very bad words here. Marley is being totally under medicated for pain while doing a washout where there is nothing at all in his body to deal with painful swelling. There is TOO much pain showing. Marley needs help at ER tomorrow morning asap. Gabapentin alone is not doing the trick. 17.5 pounds
Pred 5mg 2x/day for 5 day to star 2/17 , then taper.
Gabapentin 50mg 2x/day
Pepcid AC prescribed?John, what did the vet say when you advocated for Tramadol as the general pain reliever, methocarbamol as the pain reliever for muscle spasms associated with a disc problem? The goal of our Forum is to support you, to teach you how to learn to look up things, question everything and read so you become the most important part of Marley's health care team. By doing your own reading, making your own notes, your own list of questions, you OWN future conversations with your vet. Your vet will understand why you are hiring them, what your financial situation is re: treatments, surgery, etc. You become the captain of the health care team. So naturally you will want to be an integral part of making decisions and work closely with the vet you have hired. Dr. Nancy Kay, DVM, ACVIM highly recommends this kind of relationship 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!" www.speakingforspot.com/PDF/Medical%20Advocacy%20101.pdfMarley, now needs you to step up to the plate, in strongly advocating for the pain meds he needs. This vet appears to not be very comfortable in treating a disc episode. This means he would have to be open to what you have learned or you will need to find a new IVDD knowledgeable vet asap… they ARE out there. Some ideas and approaches to finding a new vet: www.dodgerslist.com/literature/VetchkList.htmLift and Carry video at Dodgerlist YouTube: www.youtube.com/user/Dodgerslist/videos The main thing is to support both ends and to keep the back horizontal to the ground as you lift up and carry Marley. |
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Post by John & Marley on Feb 16, 2014 1:22:27 GMT -7
I need to clear one thing up, I am far from defending the actions of the Vet. Marleys first Visit was with one Vet in this practice who put him on the Deramaxx with no Pain Meds. The On the 2nd visit on Friday after being snow bound we saw the Other Vet / Owner of the practice ( totaly Different from the first Vet ) the 2nd Vet is the one who put Marley on Gabapentin with the Prednisone to start on Monday. I agree totally about being undermedicated for the pain to deal with the swelling. The 2nd Vet said that the Gabapentin would do it and Tramadol wasnt needed in conjunction with it. Clearly it is not, Marleys last Deramaxx was Wed at 5pm, With my reading of the flush out it says 4 to 7 days, so would Sunday night be 4 nights and a POSSIBLE Starrt of Prednisone ? John, I'm aghast at a switch, a washout without any appreciable compensation for expected pain when no anti-inflammtory would be on board and this happening over the weekend when he is not open to confer with. This vet never Rx'd ANY pain med right from the start, that is why the pain was never in control, he only Rx'd Deramaxx. Now he still gives no real pain relief, gabapentin alone would not likely fully control pain. Sorry, but I really want to say some very bad words here. Marley is being totally under medicated for pain while doing a washout where there is nothing at all in his body to deal with painful swelling. There is TOO much pain showing. Marley needs help at ER tomorrow morning asap. Gabapentin alone is not doing the trick. Read more: dodgerslist.boards.net/thread/1427/johns-marley-2-5-conservative#ixzz2tTEYPqIT |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Feb 16, 2014 7:05:06 GMT -7
Since Marley had the Deramaxx on Wed., even though it was in the evening, I would count Thursday, Friday, Sat. & Sun. as the 4 days minimum necessary to wash out the NSAID from Marley's system and start the Prednisone on Monday morning. Be sure to include the Pepcid AC 5 mg 30 mins before the first dose of Pred and then every 12 hours thereafter. You still need to address Marley's pain today. Do you have an ER facility available to you where you can take him this morning? Or possibly you could try calling other vets to see if they have any emergency contact today. By reaching out to a vet today about Marley's pain, hopefully you'll be given better direction concerning the anti-inflammatory, too. A more knowledgeable vet may tell you today to continue with the Deramaxx. The vet you've hired for Marley's care is saying loud and clear that he's not comfortable in treating IVDD. Not all vets are. Finding the correct vet will make all the difference in Marley's care. Board-certified neuros (ACVIM) and ortho (ACVS) surgical specialists can be found at University vet teaching hospitals. You can locate others in your area here: www.acvim.org [neuros] online.acvs.org/acvsssa/rflssareferral.query_page?P_VENDOR_TY=VETS [orthos] Dodgerlist Members' vet recommendations - dodgerslist.boards.net/board/10/guidelines-postingOr if you'd like to let us know where you're located, we might be able to help you find a more knowledgeable vet who can meet Marley's needs. Please keep us updated. Prayers for you and Marley. |
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Post by John & Marley on Feb 18, 2014 20:58:30 GMT -7
Marleys Update, He is now on Tramadol - 50 mg twice a day in conjunction with the Gabapentin twice a day. On Sunday we changed his twice a day / every 12 hrs dosage of Gabapentin to every 10 hrs till we were able to see the VET on Monday which is when we got the Tramadol. On Sunday with the change of delivery from 12 to 10 hrs with that switch he wasn't in pain any more. Since adding the Tramadol he has shown no pain or had any high temperatures and is alert and TRYING to be more active. Trying being the fact that he is not allowed and his crate area is only 19 x 23 so he can only do so much. Also his Pain meds are spaced so they are given a few hrs apart so they over lap and less of a high and low.
Also on Monday Marley started his Prednisone On Monday he had his 3rd Laser Treatment and will have # 4 on Wed afternoon. He eating normal and doing biz normal.
This all started on Feb 5, but since he wasn't able to be on the right meds till Monday we are starting the CLOCK on his recovery for Crate Rest as on Monday the 17th. So he is on day # 2 of week one for his 8 week recovery.
Thanks again for that video on how to pick him up, gives much more support to his back also thanks for all the expertise , help and concern for Marley's health.
John
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Marjorie
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Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Feb 19, 2014 5:51:55 GMT -7
Excellent job on advocating on behalf of Marley, John! I'm very glad to hear that Marley's pain is now under control and that he's feeling better. If you see any signs of pain arise, please know that the vet can increase both the Tramadol and the Gabapentin to every 8 hours. Here's an updated list of Marley's meds - please let us know if this is correct.
17.5 pounds
Pred 5mg 2x/day for 5 day, then taper 1 tablet once a day for 5 days
, then 1 tablet once a day every other day
Gabapentin 50mg every 10 hours
Tramadol 50 mg 2x/day
Pepcid AC prescribed?
Are you adding the 5 mg of Pepcid AC 30 mins before the Prednisone and then every 12 hours thereafter? It's very important to protect Marley's GI tract BEFORE an issue arises from side effects.
It looks as though a taper of the Prednisone will be starting this weekend. Keep a close eye out for any signs of pain during the taper of the Prednisone. Pain = swelling = more time on the anti-inflammatory level of the steroid (5 mg 2x/day). Check with your vet before the taper starts as to what you should do if you start the taper and then see signs of pain arise. Find out if there is a contact number where you can reach the vet on Saturday and Sunday. All too often, we have members who are stuck on weekends with no way to reach their vets and don't know what they should do. So it's best to be prepared.
Please keep us updated. Healing prayers for Marley.
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Post by John & Marley on Feb 19, 2014 9:15:33 GMT -7
Gabapentin is every 12 hrs now ( we only had him on a 10 hr window when it was the weekend and we couldn't reach the VET and it was the only Pain Med to give him ) since then he is now on Tramadol as well so with two pain drugs spread out he is responding to this regimen - being alert, clear eyed yet sleeping and not being over sedated drowsy and wobbly.
[17.5 lbs.]
Gabapentin [50 mg] given at 9:30am and 9:30pm Tramadol [50 mg] given at 12:30am and 12:30pm Prednisone [5 mg] given with each meal first at 7:15am and 2nd at 6:30pm, then taper 1 tablet once a day for 5 days
, then 1 tablet once a day every other day Pepcid AC given 30 min before each meal.
I personally don't like to give more than one drug at a time , I feel its too much for the system to process so its why I spread out the drugs, Both Gabapentin and Tramdaol are given with a small treat ( 2 grape size portions with each pill ) I work from home so can plan it easily.
This morning after Peeing he lifted up his tail and was waving it, a good sign - he IS NOT ALLOWED to WALK, once he does BIZ he is picked up as I learned in your Video.
Today he goes for his 4th Laser Treatment. Marley only gets picked up when he goes Potty. I took a metal Tray ( Firm & Sturdy ) out of another crate and lined it with fleece so its nicely padded but firm. This tray is slid in and out of a crate when and the tray is what he is transported into the VETS Office and the Tray is put on the Exam table and stays in the tray for exam's and Laser treatments, So Marley maybe is lifted 4 - 5 times a day just to do biz. Rest of time Solitary Confinement for him.
You mentioned Pepcid AC 12 hrs after a meal, Marley is fed almost every 12 hrs at which time he gest the Pepcid before those two meals , I am thinking that is OK ?
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Now for the BIG BIG QUESTION. PREDNISONE and Tapering Yes Marley is on : 2 x day for 5days on Prednisone which is to start the taper on Sat to one a day for 5 days and then one Prednisone every other day finishing off the last 5 pills.
You are correct about the weekend and not being able to be in touch with the Vet. I hate to YO YO Marley on his Prednisone. Sat would be a one a day for Prednisone , his first and I wouldn't expect to notice any pain or discomfort till late Sat evening or Sunday.
Marleys Back acted up on Feb 5th, and due to a calamity of events he has been yo yo'd on Drugs and didn't get the right Cocktail of them till This Monday just 3 days ago. Just 3 days on the right Combination and this all started 14 DAYS AGO. My question is that with what transpired would it be wiser to keep him on two ( 2X ) Days of Prednisone for more then the prescribed 5 days , say 7 days (or longer) then start the taper to one a days for 7 days and so on. Since the Prednisone is doing the reduction of the swelling which permits the healing to start I hate to end it prematurely especially since being on two pain meds he may not exhibit any outward indicators.. What are the RISK by keeping him on 7 or 8 days of 2X a days if he isn't having a reaction to them currently ?
I do plan on asking the Vet on Friday, He has been great on returning calls promptly during business hours. But I am wondering what others have done besides the typical prescribed 5 days @ 2 X a day then 5 days @ 1 X a day and then 1 a day every other for 5 intervals ? Sounds like typical formula used.
Thanks again for all the HELP ....... John Marley :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
It looks as though a taper of the Prednisone will be starting this weekend. Keep a close eye out for any signs of pain during the taper of the Prednisone. Pain = swelling = more time on the anti-inflammatory level of the steroid (5 mg 2x/day). Check with your vet before the taper starts as to what you should do if you start the taper and then see signs of pain arise. |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Feb 19, 2014 10:08:19 GMT -7
Each vet has their own way of tapering off of Prednisone. It's really just a guess as to when the taper should start. The taper is a test for pain and to signal the adrenal glands that they need to start making their own steroid again. You can certainly speak to the vet about extending the time to taper to 7 days. However, if he wants to stick with the 5 days, remember that this is just a test and Marley can be returned to the anti-inflammatory level. You just need to be able to reach the vet if pain arises so he can advise you and you need to have a plan in place for the weekend as to what you should do if pain arises. I know you just got Marley to a pain-free place, but usually when the taper of the Prednisone is started, the pain meds are also tapered or stopped so a true test for pain can be made. You should speak to the vet about that, also. You're right - the pain meds will mask the pain and it will be difficult to determine if there is still swelling during a taper of the Prednisone alone. The way you're giving the Prednisone and Pepcid AC is fine. Marley has a good advocate on his side. You're doing a great job thinking things through and questioning everything. Marley's a lucky boy!  |
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Post by John & Marley on Feb 19, 2014 11:13:49 GMT -7
Quick ? on Pepcid AC and Prednisone
When I do go to tapering to one a day on Prednisone, I should still give 5mg of Pepcid Ac twice a day 12 hours apart ?
and the
when I go to one Prednisone every other day - Pepcid AC twice a day 12 hrs aprt
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,555
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Post by PaulaM on Feb 19, 2014 14:32:11 GMT -7
I would continue with Pepcid AC 2x a day until fully off of Prednisone. Fingers crossed for a good taper this weekend with not any signs of pain.
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Post by John & Marley on Feb 20, 2014 19:06:54 GMT -7
With the tapering off of Prednisone starting Sat, I am still planning on continuing with the Gabapentin with my supply of that running out Sunday night. Also continuing the Tramadol ( in conjunction with the Gabapentin ) also Till it runs out a Week from this Fri Feb 28, currently giving him 2 a day of Tramadol. So Im wondering how Ill notice the pain aspect. Fri Feb 28th is when he starts On Prednisone tapering to every other day and would be with out any Pain Meds. Is that the best way to wean off Pains while weaning off Prednisone ?
Marley Did see another Vet while getting his Laser Treatment and She Commented how great his responses were and his neuro responses were. She found the area where he seems to be sensitive and were focusing the Laser on that area. He is scheduled for # 2 of 6 Treatments on Sat, 3 treatment's the following week, then reassessing how many more after that per week.
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Sabrina
Helpful Member 
My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Feb 20, 2014 20:32:18 GMT -7
Hi John - I hope that the laser treatments help Marley as his body works on healing from this episode!
With pred tapers, the best thing to do is to discuss with your vet how to either back off of pain meds or stop them entirely - like you said, if the pain meds are masking the pain then you won't know if it's too soon to taper the pred. It's best to back off of/stop the pain meds before or at the same time as the first step in the pred taper (under your vet's instructions).
))Hugs!((
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Post by John & Marley on Feb 20, 2014 21:27:42 GMT -7
For a Non Surgical Incidence like Marleys is
5 days On Prednisone 2 X a Day
the norm ?
I understand the Taper aspect, I understand tapering to same time line as you gave the 2 X a days and then matching it with alternating for 5 times.
Just wondering if 5 Days is sufficient ?
TY
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Post by John & Marley on Feb 20, 2014 21:33:39 GMT -7
Sorry for so many questions, Now that Sat will be Marley's Taper off day, when would be a time to start some Physical Therapy ? He walked fine for the VET on Wed, normal,,
But Im wondering with him staying in a 23 x 18 area muscles wont be used and he will be in there for 6 - 8 weeks. ( 5 more Weeks from now )
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