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Post by Victoria and Allison on Jan 23, 2015 8:51:05 GMT -7
Thanks Debbie and Paula!! Charlie is doing great today, so Paula you may be right about dodging the bullet! Whew! And a blessing in disguise too because I know how I have to keep my other dog away from him! I'm guarding Charlie like a hawk now! I don't see any knuckling. One paw lick, one leg lick and no other signs at all. His walk was strong when he went out to pee this morning and he barked hardily at the neighbor's gardener and a few tail wags for me as well I'm doing pumpkin with every meal, I've made it a part of his regular diet- is that advisable? I saw some laboring to poop this morning. Do you think metamucil is warranted? Or anything else? Also, since he seems to be doing well. do you think the 7 straight days on pred is warranted? I went ahead and gave him pred for the last 3 days straight days and am thinking maybe a total of 5 instead, then tapering? Vet hasn't answered calls yet. Thanks again!
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Post by Debbie Blackwelder on Jan 23, 2015 10:18:28 GMT -7
Victoria, that is such great news to hear and I know you are relieved that Charlie is doing so good. I found an article online from RaisingHealthyDogs.com and it gives the dosage for large dogs on pumpkin. My vet told me to give my Dachshunds one teaspoon of pumpkin, once a day and this works with three of them, but I do have one problem child who stays constipated, so she gets one teaspoon three times a day and it works for her, but we didn't start her out that way, we just gradually worked her up to that dose. This article says for large dogs to give two tablespoons, I assume once a day. You might want to check with your vet to be sure. I would stay with the pumpkin right now and not go with the Metamucil unless your vet tells you to do so. Pumpkins are very rich in fiber and even adding two teaspoons of canned pumpkin in you dog’s food helps the digestion process. Give your small dog one and a half to two teaspoons of canned pumpkin. For a larger dog give two tablespoons instead. www.raisinghealthydogs.comI would also talk to your vet about the Prednisone. If he leaves it up to you and it were my puppy I guess I would continue with the planned 7 days as a "just in case" scenario, then taper and watch for signs of pain to return. If there is no pain, then continue with the taper, but if pain returns you may have to go longer on the Pred. Good Luck and so glad he is doing so good.
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Post by Victoria and Allison on Jan 25, 2015 19:29:53 GMT -7
Hello there. Charlie has done OK, but knuckled under left back paw yesterday just for a minute and same thing today with other back paw. But he still walks for pees and wags his happy tail. Also has a really strong appetite.
This evening he grunted about 6 times while laying down.
The pain could be his back, his stomach or his ears, he has to get them cleaned every week or they drive him crazy. I'll clean them tomorrow.
So if it is nerve-related pain, what can be done? His Meds: 1 prednisone 20 mg daily for 7 days, then taper (second round) 3 50mg tramadol every 8 hours, 7am and 3pm, and I confess being in bed for the last dose but by then Charlie is also alseep. 1 300mg gabapentin Famotatine 2x's daily before food
If he keeps grunting do I ask vet for robaxin? Or increase meds he's on? or?
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Marjorie
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Post by Marjorie on Jan 26, 2015 5:58:09 GMT -7
Tramadol has a short half life and works best when given consistently every 8 hours. Could you possibly given it to him at 6:30 am, 2:30 pm and 10:30 pm? Or set an alarm to give him that last pill. Tramadol dosing is 3 to 5 mg/kg (0.5 to 2.5 mg/lb) every 8 hrs to QID (up to 6 times daily at lower dose) Anecdotal reports include 10 mg/kg QID for more severe pain vasg.org/t_drugs.htm#TRAM So your vet does have room to move up on the Tramadol but first you need to give it consistently every 8 hours as prescribed.
How often is the Gabapentin being given?
If the three doses of Tramadol doesn't keep his pain under control, then yes, you can ask that Robaxin be added to the mix.
You should be giving Famotidine 30 mins. before the Prednisone (Pred should be given with food) and then every 12 hours thereafter for as long as he's on Pred. It sounds like that may be what you're doing but just wanted to confirm.
We are not vets and do not know the specifics of each dog's health. We are making this suggestion based on what we've seen qualified vets prescribe in the past and only as a basis for discussion with your vet. You need to contact your vet, report your dog’s symptoms and discuss adjusting the dose. The correct amount to administer can depend on several factors including your dog’s breed and medical history.
Since Charlie is still showing signs of pain, it's not time for a taper of the Prednisone, which I believe will start in a day or two. Please speak to your vet about any sign of pain that you're still seeing and ask that the anti-inflammatory be continued for a few days.
Please let us know how Charlie is doing and whether he's still showing any sign of pain or whether his ear cleaning helped.
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Post by Victoria and Allison on Jan 29, 2015 8:52:50 GMT -7
Thanks, Marjorie! I am seeing signs of weakness in Charlie's rear legs when on potty walks. He draggs paws but not quite knuckled. But wide stance and weak when slow when he speeds up walk looks stronger. He now grunts when hungry. I think there's a frustration thing but because of weakness probably some pain? Some arm licking but not continually. Appetite very strong. I'm going to have to find a vet that will go with the prednisone/conservative program, I don't think this specialty clinic that likes doing surgery is too keen on it. Any recommendations for near Upland, CA?
So do you normally see that ONGOING pred is necessary with this weakness or is it merely during pain stage and the CRATE is what will ultimately help?
THANKS for always being there!!!!!!!!!!
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PaulaM
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Post by PaulaM on Jan 29, 2015 9:36:19 GMT -7
Victoria, with CES we really do not feel comfortable in commenting...it is out of our realm of knowledge. I hope you can understand our not wanting to cause any harm in an area we know nothing about. All I can say is when a disc presses on the spinal cord and causes nerve diminishment (dragging, knuckling) an anti-inflammatory is used to get down the swelling. Inflammation is painful and thus the use of pain meds til the anti-inflammatory can get the swelling down is how it is handled with an IVDD dog. To get a handle on how inflammation and pain works with a disc episode you may wish to read these two pages in preparation to discussion about CES with your vet. Before discussing pain meds, these articles can give you good background information: www.dodgerslist.com/literature/healingpain.htmwww.dodgerslist.com/literature/healingsweling.htmThe prescription of crate rest for IVDD serves only for the purpose of allowing a disc to heal. That is the disc is healing by forming scar tissue where there was a crack, a tear so no more disc material can escape into the spinal cord canal. There are no meds to heal a disc just time and limited movement. You can check our directory to see if any one has a recommendation. www.dodgerslist.com/literature/surgerycosts.htm Have you had a heart to heart conversation with the current vet. Is surgery an option at any point? If not an option, what can the vet do to HELP Charlie, get the swelling down and cover pain? What can the vet do to make sure Charlie is going to be able to live with his family in comfort during this healing period? And what can the vet do after the disc healing period to provide comfort if there still would be some pain...what options are there? Similar to people who have back aches might take perhaps a low dose med to allow them to carry on with life?
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Post by Victoria and Allison on Jan 29, 2015 21:15:31 GMT -7
I imagine a re-injury is more serious and can take longer to heal. I'm trying to understand the "average" time period for inflammation to subside, though understanding each dog is different. But would it be ONE course of steriods for a week? Two weeks? A month? What time frame to heal do you generally tell IVVD dog owners?
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Post by Pauliana on Jan 29, 2015 21:43:09 GMT -7
Hi Victoria,
For IVDD we usually say it can take from 7 to 30 days on a Steroid or a NSAID to get the inflammation/swelling down.. When the steroid is tapered, pain meds are stopped and if no pain shows during the taper, that means the swelling is gone. If pain shows that means the swelling is still present and more time on Steroids and pain meds are needed. Healing is another story, nerves are the slowest part of the body to heal. Thousands of IVDD dogs on Dodgerslist have regained functions in as little as 2 weeks, others 11 months, and still others 3 years later. IVDD is a disease of patience to allow the body to heal on its own terms. Acupuncture and Laser Therapy stimulate the cell’s metabolism that leads to the body’s natural repair abilities and can be started at any time.
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Post by Victoria and Allison on Jan 30, 2015 6:56:34 GMT -7
Wow a fantastic explanation, Paulina, and I've read the info before, but this is so crystal clear!
Charlie was acting again so happy this morning! I realized that I'd only been giving him gabapentin 2x's instead of 3 and I picked it up, and getting that 3rd dose in with the tramadol. I go to bed early for health reasons but now I'm making an extra effort and pray this works. THANKS AGAIN!!!!!!!
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Post by Victoria and Allison on Jan 30, 2015 15:58:12 GMT -7
Anyone know how to get in-home laser or acupuncture for dogs in Southern Calif?
I just spoke with the vet and he agreed to continue prednisone daily for another week and to add Robaxin to see if it helps Charlie.
He also said to call local vets and for acupuncture and lazer recommendations.
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Marjorie
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Post by Marjorie on Jan 31, 2015 7:22:16 GMT -7
What is the dosage of the Robaxin that's being added, Victoria? Please give us a complete updated list of all meds currently being given.
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Post by Victoria and Allison on Jan 31, 2015 15:23:20 GMT -7
Charlie is in pain. He can walk. But obvious his rear is weaker. Wider gait event than before. Dragging paws but no knuckling. Anxious to eat. Panting at times and moaning/grunting at times when laying down. He does not normally moan or grunt.
I can't yet find an acupuncturist that is near me or will come to my home. So getting him in/out a care is going to be a problem.
I gave him an exra 2 tramadol 4 hours after the last dose. I am on my way to store to pick up the Robaxin which has not been tried yet. PRAYING this gives him some relief.
My gosh. We were so close to maybe beating this. My heart is broken. He always been so spectacularly good and deserves so much better.
85 lbs Pred 20mg 1x a day for one week, then evaluate. Robaxin 500mg every 8 hours Gabapentin 300 mg ever 8 hours Tramadol 3 tablets 50mg each, every 8 hours
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PaulaM
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Post by PaulaM on Jan 31, 2015 15:58:17 GMT -7
Let us know when you get Robaxin in him, how that does to control pain.
The most important care is the 100% STRICT crate rest 24/7 that you can manage with an 85 lbs dog. I would opt to NOT transport him to acupuncture... crate rest would the more important of the two IF it is a damaged disc involved.
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Post by Victoria and Allison on Feb 1, 2015 11:30:10 GMT -7
Gave Robxin last night and may have helped Charlie be less restless and sleep. He is still in pain because he grunts occasionally while lying down and upon standing up. Still can walk, but back right leg especially showing weakness. He knuckled under when standing on his bed. Moans for his meals the last few days. He seemed very sleepy this morning after his meal, all the meds?
Anyone have a good recommendation for a bed, large size? I wish I could get a recommendation for in-home acupuncture to give him some relief.
If you have ideas for pain relief please let me know. Do you see increases beyond what vet has prescribed? I'm not asking for med advice, just what you have seen.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,605
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Post by PaulaM on Feb 1, 2015 12:13:47 GMT -7
A grunt is not necessarily a sign of pain, could be a sign of effort/strain to move. Usually pain will have more than one sign which is helpful in deciding if there is pain. So are you seeing other signs of pain other than a grunt? shivering, trembling, yelping when moved or moving himself, reluctant to move much or moves gingerly, tight tense tummy?
A good choice for a mattress that helps to prevent pressure sores from laying around all day is an egg crate or memory foam. It would need to be enclosed in a waterproof bag to avoid it getting ruined via liquid accidents. 2" Memory foam toppers for a twin beds can be found at Target, KMart, type stores. You can cut the foam down to size needed with scissors or a serrated knife, stack two layers, for a comfy bed. Check with fabric stores they likely will carry egg crate foam, upholstery shop may also carry foams.
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Post by Victoria and Allison on Feb 3, 2015 19:55:29 GMT -7
Charlie doing OK, better regarding possible pain. Tail wags. Voracious appetite (prednisone?) But seeing that weakness in rear paw dragging with knuckling only about once every couple days and just for seconds. Would asking vet to increase prednisone, dose/frequency give Charlie a better chance of gaining back more rear strength faster? Am I being impatient? I'm praying he will regain where he was. His first back episode he seemed to recover after 3 weeks. His second injury was Jan 20th and it seems he's not doing as well at the 2 week mark as he first time. I tried again to find an in-home acupuncturist. Someone told me I could buy a laser machine myself and it's not hard to learn. Ever heard of anyone doing that? I found someone in LA that does 'aquapuncture' with fluids into points. Heard of that? I'm much better at the strict routine now: confinement, meds, no dogs. Got a flat commercial-carpet type rug for him to walk out the door and it is sooo much better than the blanket. No slides Hope everyone here is experiencing some success
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Post by Pauliana on Feb 3, 2015 20:41:40 GMT -7
Hi Victoria!
Prednisone won't bring back Charlie's strength faster. It is an anti inflammatory that works on inflammation and swelling. Rear paw dragging and knuckling is from nerve damage and nerves are the slowest part of the body to heal. It takes time. CES is a disease I have no experience with and I don't know how it affects rear leg weakness but knuckling and dragging sounds like nerve damage and time is the best healer and unfortunately there is no way to tell how long it will take..
What does your vet say about the weakness and knuckling?
No, I have never heard of aquapuncture, sounds interesting. I'll have to research that.
Buying a laser machine is what our local Vet did and she learned to operate it and taught her Vet Tech's. She charges so little for a laser appt, we never did look into buying one. We live in a very small rural community so they don't charge an arm and leg for Vet care here, but the care is fantastic, thankfully. If it's anything complicated, however, we head to Purdue University Vet Teaching hospital a half hour away..
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Post by Victoria and Allison on Feb 4, 2015 14:35:12 GMT -7
Success! I found an acupuncturist! In fact, I found TWO that will come to my house!! I kept calling vets and found they out-service acupuncturists, who come to their offices about once a week. I got the name of them, Googled them and called direct and they will do home visits! The first one is a local vet who does all-things vet practice. The second one is a vet who apparently specializes in just acupuncture because she does this for other vets. She lives in another county but visits my county 2x's a week. She charges $70 a visit, the other charges a $140 first visit plus $40 for travel, every visit after that would be $70+ 40 for travel. I chose the specialist and we start Friday! She does not do laser, so we will see, first, if Charlie allows her to put needles in him, and second if it helps. Luckily the vet loves pit bulls and Charlie is 1/2 so that's a good start Yea! BTW Charlie was very spunky today.
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Marjorie
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Post by Marjorie on Feb 4, 2015 14:46:18 GMT -7
Great news, Victoria! I'm glad you chose the specialist. Often, a regular vet takes a few lessons in acupuncture and uses it in their practice but doesn't use it enough or know enough about it to be effective. Just one word of caution - many acupuncturists also believe in chiropractic treatments, which can be very dangerous for an IVDD dog. So educate yourself about chiro and IVDD and if the acupuncturist suggests it, you'll know enough to say "no". Some readings in preparation: www.dodgerslist.com/literature/chiropractic.htmwell.blogs.nytimes.com/2013/08/22/chiropractors-are-going-to-the-dogs-and-cats/?ref=health&_r=1Let us know how Charlie likes those needles. My Jeremy loved his sessions. The acupuncturist put one needle in his forehead and my normally very hyper dog laid down like a lamb for the rest of his treatment.
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Post by Victoria and Allison on Feb 4, 2015 19:39:13 GMT -7
Thanks, Marjorie! No chiro for Charlie! There's one thing that concerned me. When I called the first vet that does acupuncture along with his practice, I spoke with his vet tech. She asked for blood work and x-rays. I liked that. But the acupuncture specialist didn't ask, so I offered and she said I could show them to her but it wasn't essential or that important. Is that a concern to you? I'm going to have them for her anyway.
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Marjorie
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Post by Marjorie on Feb 5, 2015 5:50:14 GMT -7
I wouldn't be concerned at all that the specialist doesn't care about seeing x-rays or blood work. Acupuncture treats the whole body. It helps the body to self-heal and helps regulate the flow of energy in the body. There are certain pressure points for specific conditions. The acupuncturist will know where to place the needles according to symptoms and may not even know what to look for in an x-ray.
I hope the treatment helps Charlie.
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Post by Victoria and Allison on Feb 6, 2015 12:53:07 GMT -7
Charlie had his first Acupuncture!! I can't believe he didn't jump around and fight it - AT ALL! When I clean his ears he's very nervous and anxious. I honestly didn't think he would let anyone put needles in him. I was wrong, thank goodness! Note: I have some photos I'm going to try to post. And I loved the lady who did it! She isn't a vet, she got her doctorate in acupuncture. She said vets get a 2 week course and she studied acupuncture for five years. She is a real pro. Charlie was so relaxed with her! He got real sleepy afterward. She said some dogs get 'knocked out' afterward. He's sleeping now She's going to come weekly. Earlier this morning (before acupuncture) the housekeeper said, "There's a puppy outside." I thought one came in under the fence, and found out she was talking about Charlie! He was romping when he went out to pee.
Now that he is starting to feel better (!!) I'm thinking about when cutting out methocarb and gabapenin and tramadol and prednisone (taper). I think the vet (surgeon) is going with my suggestions- at least he did when I asked to restart pred and the rest. What is your experience about 'the right' time to taper?
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PaulaM
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Post by PaulaM on Feb 6, 2015 17:57:03 GMT -7
A taper is done when the vet guesses all the swelling might be gone. The taper is a test to find out that answer.
Is there anyway to supervise Charlie when out at the potty so he is not romping around, but walking slowly, quietly?
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Post by Victoria and Allison on Feb 7, 2015 7:29:00 GMT -7
As much as you all explain this so well, I want to make sure I get this:
The way to determine whether there is INFLAMMATION is to determine if there is PAIN? And the neurological deficits like knuckling under, paw dragging and weak rear legs are signs of NERVE DAMAGE, so they they can linger on, even when there is no more inflammation?
For the last few days Charlie is not licking, panting, trembling, yelping when moved or moving. He is not reluctant to move, there's no tight tummy, and he is wagging a happy tail. He seems very relaxed, and is now sleeping soundly where before he was restless and overly alert.
He is however exhibiting 1-2 times a day knuckling under, some paw dragging and his back legs are still weaker than before his 2nd injury.
I am taking away the methocarb because the vet said to use that only because the trama/gabapentin was not curtailing his discomfort.
The vet prescribed the tram/gabapentin 'as needed', though I know you all mention it has to be round the clock because of the short life. But I am thinking that if Charlie maintains where he is at for the next few days, he is ready for tapering?
I'm only callling the vet and describing Charlie's status, without visits, because I don't want Charlie climbing in/out of the car and all the walking to the vet office. Under these circumstances, when should I suggest he start tapering?
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Marjorie
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Post by Marjorie on Feb 7, 2015 7:43:16 GMT -7
Yes, that's exactly right, Victoria. The swelling is pressing on the nerves of the spine causing pain. Once that swelling has resolved and is no longer pressing on the nerves of the spine, the pain will stop. It still takes the full 8 weeks of crate rest and limited movement of the spine for the disc to fully heal and form scar tissue. The damage that has been done to the nerves (which can be seen from neuro deficits), however, can take months, even a year or more, to heal. So glad to hear that Charlie did well with the acupuncture! Sounds like you found a winner in this acupuncturist. Let us know what the vet says after speaking to him about his opinion on starting a taper at this time. And you're right - during a taper of the Prednisone, the pain meds need to be stopped for a true test for pain to be made.
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Post by Victoria and Allison on Feb 18, 2015 15:25:35 GMT -7
Hello all. Just checking in. Charlies been tapering since 2/11. He's doing really well. Of course I'm being sooo careful not to let another accident happen. Charlies been confined since 12/3 and because of the incident where the other dog jumped on him, he won't be 'free' until 3/18!
He's not exhibiting pain. He's happy, wagging, eager to walk out to pee/poo. His stomach is fine. I almost never see any licking and it's usually wiping up water he drips when drinking. Once in a while I see the dragging more pronounced. Have not seen knuckling for a week. He's still weaker in the rear than before all this started early December. I was shocked to see the photos I took back then, he could hardly stand, let alone walk, totally crossing rear legs and paws that would not unknuckle. Your group has been such an inspiration and source of invaluable info. My next challenge will be how to manage Charlie OUT of the pen; tile floor and a dog just waiting to jump on him. I know I will have to find permanent solutions.
By the way, Charlies is still getting acupuncture. It really relaxes him and hopefully is stimulating nerve healing. I found out in a conversation the woman, who is not a vet but has a PHD, also has a practice for people! So she is doing me and Charlie every Friday. Ha! So we are both feeling better!
How long should tapering continue? The vet is open and leaves this to me, I think 7 days is enough, no?
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PaulaM
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Post by PaulaM on Feb 18, 2015 16:28:08 GMT -7
Victoria, good news on the taper... of no pain, knuckling gone!
It is you and the vet who will work together on the taper. The vet will give you the number of days to reduce and then finally end in an every other day dose.
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Post by Victoria and Allison on Feb 18, 2015 22:42:01 GMT -7
Thanks, Paula! I hope it is OK, he had me go from Pred 20mg 1X every day to every other day for a week or 10 days and that is it. That sound right?
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Marjorie
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Post by Marjorie on Feb 19, 2015 5:28:52 GMT -7
Every doctor has their own way of looking at tapers, Victoria. I'm sure a lot of factors go into that decision, such as how long on the steroid, weight, status, etc. A tapering has to be done under a doctor's supervision. Just continue to keep an eye on Charlie and see if any signs of pain or neuro diminishment return and of course let the vet know ASAP if that happens.
Prayers for a pain-free taper off of Prednisone for Charlie.
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Post by Victoria and Allison on Mar 11, 2015 10:40:54 GMT -7
Hi, Charlie confined since December, due to be 'free' 3/18. He is uncomfortable, panting last 2 days. I gave him tramdol and gabapenten to sleep. Legs weak in back, not as strong as when tapered off pred. No known incidences that would have caused this. Suggestions? If start prednisone again does confinement start all over?
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