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Post by carlette on May 13, 2013 16:03:27 GMT -7
This was my post on your FB page earlier today: Hopefully someone can give me a little help. Last week my Bella was holding her front paw up and having trouble walking. I took her the vet the next day and he did x-rays but didn't see anything. He said it was a slip disk or a hurt shoulder and gave her Novax. It was doing nothing for the pain and she was crying. So I gave her Tramadol over night and went back the next day. They said to just keep giving that to her and to come back in a week. So and a today they said to give her the Novax again gain she is in pain and crying. What have your vet given your furbabies for a possible slipped disk? I cant stand seeing her in pain! Now to add to this she is back taking Tramadol for the pain and Flagyl ? ( I think that is what is written on it) for her tummy. We tried giving her Novac but her ears turned bright red and she started scratching like crazy. So we think she may be allergic to them. I just read your article to get you started on conservative treatment. BTW thank you for who ever posted that on my FB question it did help me  . So which is better to use Steriods or NSAID? You cant use both right? My concern is the vet gave her the Novac then Tramadol and the article said to wait between using them and we did NOT. Also in the article it has if she was holding her leg up it had (nerve root signature) what does that mean? As I'm sure you can tell I am a total basket case. I have moved to Miami and now have a vet that I have never used. I loved my vet in Georgia and would feel fine with him but this one is doing things different than I'm used to and I am worried to death right now. Any help you can give I would forever be grateful for. I'm just concerned that he does not have her on any anti-inflammatories but they said that the Tramadol had them in it and that would be fine. Is that right? It seems like she should have a pain medicine AND a Anti-inflammatory. |
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Post by carlette on May 13, 2013 18:14:15 GMT -7
A week ago Bella started holding her paw up so I thought that she had hurt her shoulder. She has done this in the past when chasing a lizard so I thought that was how she hurt herself. She was eating fine, wagging her tail and didn't seem to be anything else wrong. However that night I did notice she has gas really bad. The next day she had slight diarrhea and the gas was worse. Then later in the morning she started crying so I took her to the vet. We did a x ray but did not see anything wrong. The vet said it was either a bruised shoulder or a slipped disk. He first put her on Novax and Flagyl. We think she has a reaction to the Novax because her ears turned bright red, she was scratching like crazy, shaking her head and would not sit down turning and turning in the crate. So now she is on tramadol 50 mg 1/2 tablet every 8 hours. He put her on the Flagyl because he thought that she had a little infection or irritation that was causing her to have gas and slightly lose stool. He said to keep her on the Flagyl to help coat the stomach because of the pain pills. My question is shouldn't she be on a anti-inflammatory? The vet tech said the tramadol has anti inflammatory in it. Can you tell me if this is true? On one of your pages it says that holding a leg up was nerve root signature. What does that mean? Just a little confused because the vet said he was not sure if it is her back or not. I have her in a crate which she has never been in before and she is NOT happy. However if it is her back I want to do the right thing. Any help that you can give on my questions I will be grateful for.
Thank you
Carlette
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Post by Pauliana on May 13, 2013 19:28:12 GMT -7
Hi Carlette, welcome to Dodgerslist! Here is a link to our healing index. Lots of information there to help you to become well versed in IVDD treatment and care. www.dodgerslist.com/healingindex.htmIn order to help you more please answer these questions for us: What breed is Bella? Is it her front paw that she is holding up? Can your dog move the legs at all or wag the tail due when you do some happy talk? Is there still currently pain - shivering, shaking, crying when picked up or moved? What was the date you saw the vet and started the all important 100% STRICT crate rest 24/7 only out to potty …. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM)? Novax, is the generic for Rimadyl which is a NSAID (anti inflammatory) It isn't a steroid. Tramadol does not have an anti inflammatory in it, it is a synthetic opioid that is used to treat moderate to severe pain. What are the exact names of meds currently given, their doses in mgs and frequencies? Please include the all important stomach protector such as Pepcid AC. Nerve Root Signature pain means something is irritating the nerve root as it exits the spinal cord to travel down the leg. Severe leg pain is one of the main symptoms. Not all nerve root signature problems can be resolved with conservative treatment and surgery may be required. NSAIDs may not be strong enough anti inflammatory to deal with swelling. It may take a steroid. The pain may also take a combo of meds rather than just one, such as Tramadol and Gabapentin. X-rays can help rule out other problems that mimic a disc problem. X-rays, however, will not help diagnose nerve root signature pain. An MRI is the better picture vs. a myelogram because the MRI images where the nerve roots exit the spine. Predominantly nerve root entrapment happens with cervical discs, it can also appear lower in the spine. The drugs that shouldn't be given at the same time are NSAIDS and Steroids, there should be a washout period of 4-7 days when going from one to the other. It would be wise to consult with a specialist since they see IVDD frequently and are well versed in how to treat it and they would be able to tell if it is Nerve Root signature pain or a herniated disc or something else. Board-certified neuros (ACVIM) and ortho (ACVS) surgical specialists can be found at University vet teaching hospitals. With emergencies of paralysis many hospitals waive a referral by your general vet & have ER night and weekend hours. Locate other board certified neuros/orthos: www.acvim.org/ www.acvs.org/AnimalOwners/DiplomateDirectory/No or low interest credit. You find out on-line if you qualify. www.carecredit.com/faqs.htmlYou are in good company here.. all of us have dealt with or are dealing with IVDD now with our own dogs and we know how upsetting this is but know there is every hope that your Bella will be ok with good care and treatment. Learn all you can so you can become her advocate!! Healing prayers for Bella! |
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Post by Sherry Layman on May 13, 2013 20:10:52 GMT -7
I'm glad you found us Carlette. We all know how distressing this can be when our pets are in pain. We have lots of information here on IVDD and it's important that you become educated so you can be Bella's best advocate and so you know what is best and most important for her. Here is a link to our IVDD101 page. There is a lot of information here so pick and choose what is vital now then read the rest as time progresses and the other information applies. www.dodgerslist.com/Another good page on the basics of conservative (crate rest) treatment www.dodgerslist.com/literature/conservative.htmIndeed 100% strict crate rest is the most important thing for Bella's care right now. Here is a link to our page on crate rest. www.dodgerslist.com/literature/CrateRRP.htmI am a little confused on Bella's medications. I think you meant Novox in the first paragraph (you said Novax). In the second paragraph you mentioned a reaction to Novac, is this also the Novox? If Bella is allergic to the Novox do not give it again, often allergic reactions increase in intensity with multiple exposures to the medication. Novox is a non-steroidal anti-inflammatory (NSAID), these OR steroids are used to reduce the inflammation. You are right that both cannot be used and ideally there needs to be a period of days between the two. You don't specify when her last dose of the Novox was but a conversation with your vet regarding starting her on a steroid is warranted. Bella needs to be on a medication to reduce the swelling. Tramadol is neither a steroid or an NSAID, it is a pain medication that is commonly used in IVDD episodes and is safe to use with either a steroid or an NSAID. Tramadol is not an anti-inflammatory, it is similar to a narcotic. If you are ever unsure of a drug you can start with a google search and get lots of good info. If Bella is still in pain she needs the Tramadol but she very much needs a steroid to reduce the swelling which is the ultimate cause of the pain. She may also need a muscle relaxant, muscle spasms are very common in IVDD episodes particularly those of the neck which I gather Bella's is since you say a front leg was affected. One thing to note is that disc episodes of the neck can be particularly uncomfortable and pain can take days to control as the head is always moving and the neck supports the head so patience on your part is vital. Stay in contact with your vet about Bella's symptoms but you must remain calm and of clear thought so you can communicate clearly with the vet and others to be Bella's best advocate. Bella should be on a stomach protector as NSAID's and steroids both are hard on the stomach. Pepcid (generic name famotidine) 5mg given twice daily about 30 minutes prior to the steroid or NSAID is the most effective. Purchase Pepcid at most any store. Do ask your vet if Bella has any health reasons why she cannot take Pepcid...don't ask if it's necessary or if it's ok as many vets don't view it as a necessity, ask if Bella has any health reasons why she cannot take it. It is possible Bella would get the best care at this point from a specialist, a neuro or orthopedic vet who sees dogs with IVDD daily. These vets can be found at universities with vet schools or other specialty clinics. To find one you can google neuro vet and add your town or call a 24 hour vet in your area and ask for a recommendation or even contact your vet tomorrow and ask for a referral. Can you describe Bella's pain at this point? Does she shiver/shake, does she cry, is she still holding her leg up? Can she walk on all her legs? Describe her behavior to us. Take some deep breaths and be calm. It will help Bella greatly as dogs are incredibly perceptive regarding human emotion but they don't have the ability to process those emotions so stay upbeat and positive. Staying calm will also help us help you and Bella. Hang in there, we've all been there and we know it's hard but we'll get you through it. |
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Post by carlette on May 13, 2013 21:31:32 GMT -7
Bella is a Dapple Dachshund. This started on Saturday the 5th. The first visit was to the vet was on Monday the 6th. That is when he put her on the novax but then changed it to Tramadol later in the day. She is taking Flagyl 1/2 tablet twice a day and Tramadol 50 mg 1/2 tablet every 8 hours. It is her front right paw that she would not put down. Eating fine and wagging her tail. As long as she is taking the medicine she is not yelping and doesn't seem to be in pain. However she seems to be really drugged out and is sleeping all day. Today was a week so I took her back like he told me. He said just keep doing the same thing and did not change anything. Now tonight she seems to be going backwards and getting worse. I carried her outside and she just stood there and didn't potty. It has been almost 10 hours since she has peed. He doesn't have her on any type of anti-inflammatory or steroid. which is what is really worrying me. Should she be on something else than just a pain medicine?
He did a x-ray but said he didn't see anything but also said that if it was a disk it would not show up anyways. So he is telling me he really doesn't know what it is.
If this is Nerve Root Signature is the surgery the same as back surgery? I have heard that cost anywhere between 3-5K which I do not have. I am a total mess right now and just don't know what to do.
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Post by carlette on May 13, 2013 22:34:09 GMT -7
Bella is a Dapple Dachshund. This started on Saturday the 5th. The first visit was to the vet was on Monday the 6th. That is when he put her on the novox but then changed it to Tramadol later in the day. She is taking Flagyl 1/2 tablet twice a day and Tramadol 50 mg 1/2 tablet every 8 hours. It is her front right paw that she would not put down. Eating fine and wagging her tail. As long as she is taking the medicine she is not yelping and doesn't seem to be in pain. However she seems to be really drugged out and is sleeping all day. Today was a week so I took her back like he told me. He said just keep doing the same thing and did not change anything. Now tonight she seems to be going backwards and getting worse. I carried her outside and she just stood there and didn't potty. It has been almost 10 hours since she has peed.
He doesn't have her on any type of anti-inflammatory or steroid which is what is really worrying me. I asked the vet tech today if the Tramadol had any in it and she told me yes. Which I now find out from you that it doesn't. I will be at their office first thing in the morning to find out why they don't have her on more that she is on. It has been a week and this just doesn't make sense to me. Also the first day I took her in I told them that it felt like she was having spasms in her chest. Which also makes sense now that I have talked to you and they gave her nothing for that either.
He did a x-ray but said he didn't see anything but also said that if it was a disk it would not show up anyways. So he is telling me he really doesn't know what it is.
Thank you so much for responding to the post. After reading it I am really wondering if I need to go to another vet. I am new here and don't know this vet at all. So far I am not impressed and honestly a little ticked off at the care she is getting. Not a happy momma right now. I will report back tomorrow and update what happens.
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Post by Sherry Layman on May 14, 2013 6:42:41 GMT -7
I'd like to put a few thoughts in your head, you are always free to make whatever decisions you feel are in you and Bella's best interest.
Regarding the Tramadol. Google it. There are plenty of websites that explain medications in lay terms so you don't have to be an MD to get an understanding of the purpose of a medication. You should always do this with any medication you give yourself or your dog but particularly if you have questions. Always be an informed consumer when it comes to medications. Google the Tramadol for yourself so you can have an informed discussion with your vet.
You have stated in both posts you are unsure of this vets comfort in treating Bella. Bella remains in pain. You are Bella's only voice, her only route to healing. If you are unsure then at least a second opinion seems logical. Bella doesn't deserve to have spent the week in pain. Holding her foot up, refusing to walk on it indicates she has discomfort. If you were limping on a leg it would be because it was not comfortable and you would be seeking relief. Bella deserves the same. Find another general vet or better yet start seeking out a specialist.
It's clear that you are concerned. It's clear that you want to help Bella. These are two very important things you can do for Bella. You are her one and only advocate. It's vital that you take steps today to help her on her road to healing.
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Post by natureluva on May 14, 2013 6:53:32 GMT -7
Hi, I was thinking the same thing - you need to find a new vet who is familiar with conservative treatment of IVDD. In fact, it sounds like you should get an evaluation with a Board Certified neurologist so that you'll know exactly what you're dealing with.
Bella holding up a front leg like that could indicate nerve root signature pain due to a bulging or herniated disc pressing on a nerve root bundle. Please discuss this with your new vet.
The typical IVDD meds we see given are: (1) A steroid (most effective at reducing inflammation) or NSAID, (2) a stomach protectant - usually Pepcid AC (generic is famotidine). The usual dose is 5 mg given 30 minutes before each dose of steroid or NSAID. (3) A general pain reliever such as Tramadol. If pain is not fully relieved by the Tramadol, then another med can be added in such as the muscle relaxant, methocarbomol, or the nerve pain medication, gabapentin. Gabapentin is especially effective on cervical disc pain. It works well in combination with the Tramadol.
To me, it sounds like you need to do some research and find a good IVDD vet or a Board Certified neurologist asap. Discuss Bella's symptoms with the new vet, and get her pain and inflammation fully relieved. If you tell us approximately where you live, we may be able to recommend a vet for you. We have a database of recommended vets.
The most important part of conservative (non-surgical) treatment is the 8 weeks of strict crate rest. It is time and limited movement of the spine that heals the disc. The meds only control inflammation and mask the symptoms.
Please let us know what the new vet says. Best wishes, ~Lisa
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Post by Pauliana on May 14, 2013 8:06:32 GMT -7
Hi Carlette, I have merged your topic in Emergency with your topic here in Conservative so it's all in one place so you no longer have to go back and forth to reply. It's easier in the long run to keep everything in your one topic. I echo Sherry and Lisa and feel you should find a vet that is experienced in treating IVDD. Don't waste any more time with her current vet. Directory of board-certified neuros (ACVIM) and ortho (ACVS) surgical specialists: www.acvim.org www.acvs.org/AnimalOwners/DiplomateDirectory/Tramadol can be sedating and that is why she is sleeping a lot. Just as well that she rests, that's a good thing right now. But yes she does need an anti-inflammatory to address the swelling that is compressing the spine and nerve bundle but not the Novax as she seems to be allergic to it. Has the redness and itching in her ear resolved since you stopped the Novax? We know how overwhelming and upsetting this is, we have been through it with our own dogs. The important thing is you are on the right tract learning all you can about what is going on with Bella. You are her voice..Do you have a University Vet teaching hospital nearby? They are oftentimes less expensive and they have the specialists and are up on all the latest treatments for back problems and IVDD. The one we have in our area gave my Tyler the best of care when he lost the use of his back legs. They got him on the road to recovery and while he still has IVDD , you wouldn't know it to watch him playing now. As Lisa mentioned if you let us know your location and we can check our database for a Board Certified Neuro or Ortho Vet. Here is our Faq that explains the right things to do to help Bella. Make sure she is crated 24/7 except out to potty. www.dodgerslist.com/faq.htmAlso if she hasn't urinated for over 10 hours she needs to be expressed. Please have the new Vet show you how. www.dodgerslist.com/literature/Expressing.htmThe first reason to express is to avoid urinary tract infections that can be difficult to clear up and which could ultimately lead to kidney failure. The second reason is you do not want the bladder to overflow and be stretched out of shape on a prolonged basis. A bladder that has lost muscle tone due to over-stretching may affect the dog's ability to regain bladder control, or extend the time it takes to regain bladder control.Also here are some tips to care for a dog with cervical IVDD: www.dodgerslist.com/literature/cervical.htmMy heart goes out to you and Bella.. |
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Post by carlette on May 17, 2013 8:10:16 GMT -7
Thank you so much for all the comments to my post. This is what has happened the last few days. Bella is now on predisone ? (sorry can not read the writing on the bottle for spelling) One tablet twice a day. Also still taking the Tramadol 1/2 50 mg tablet every day. She is doing fine as far as using the bathroom and I am watching for any sign of blood or any diarrhea. I am carrying her outside and not allowing her to walk around. She still has use of her back legs. However she is still holding her front leg up sometimes but other times will put it down. I think it is still hurting her because she seems to hold it up when the pain meds are wearing off.
I live in Homestead Florida and I am new here so I don't know what vet is the best one. The vet I am going to I was told was a great vet and was affordable that was the reason I went to him. As far as taking her to a specialist honestly I am not in any financial condition to be able to afford it. HOWEVER if you have some names for me please let me know. I would like to call and see what all the cost might be. If there is any way I can do it I will. Please don't judge me. As all my friends tell me I could right a book on my life the last four years and sell it for fiction because no one would believe it. Lets just say it's not been good and I am doing the best that I can. I do without just to be able to keep my dogs because to just give them away was not a option.
Right now I am keeping Bella in the crate so she will not move around or get bumped by one of the other dogs. This has been a nightmare because my other dogs are her kids and they are going ballistic because she is being separated from them. You know how Doxie's are they like to be right beside each other so they sleep beside her crate at night. This is just heart breaking for me but I'm doing the best that I can with what I have. Just please say a little prayer for us.
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Post by Pauliana on May 17, 2013 8:45:04 GMT -7
Hi Carlette! We aren't here to judge we are here to help dogs and their families through IVDD treatment.  What is the dosage of the Prednisone please? Since Bella can't go to a specialist it is up to you to learn everything about IVDD in order to teach your Vet and make sure she has the proper pain control. If she is still hurting, her pain medications have to be adjusted until she is out of pain dose to dose. Bella can't heal if she is still in pain. Tramadol is a short acting drug and for pain control for IVDD and the intense pain of cervical disc episodes it is normally given 3 times a day which works out to be every 8 hours. Call your vet and advocate for proper pain control for Bella. Nerve pain is also well controlled with the addition of Gabapentin. www.dodgerslist.com/literature/healingpain.htmwww.dodgerslist.com/literature/cervical.htmHere is a link with resourses for financial help for those with pets that can;t afford vet care. Hope this helps you and Bella! www.dodgerslist.com/links/financial.htmLots of prayers for Bella and for you.. |
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Post by carlette on May 17, 2013 9:36:05 GMT -7
The thing I hate about this vet is the write on the bottle instead of typing and it is hard to read. It looks like the Prednisone has a 5. So could that be 5 M.G? The tramadol is 50 mg and says 1/2 tablet every day. What is the M.G. for the tramadol that would be taken 3 times a day? I will call them right now about the Gabapentin. What M.G for it and how often?
I had another Doxie go down before and lost complete use of his legs and I was able to get him up and going but I also had a GOOD vet. This time has been a mess with obviously having a vet that doesn't know what he is doing! Monday I was told that he didn't give her Prednisone because pets having bad effects and vets are getting sued. Needless to say we had a nice long talk about me NOT wanting to sue him but trying to save my Bella. |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,657
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Post by PaulaM on May 17, 2013 12:14:25 GMT -7
Carlette, I've read thru your posts and I can see you are not being supported through this disc episode as you would wish. Everyone who said it is on your shoulders to read, read and read more are correct. You will need to step into position of head of Bell'a health care team by self education. You have already lobbied for the strongest of anti-inflammatories, Prednisone. This shows you are willing to be Bella's advocate. With more knowledge you can continue to advocate for the right things. An excellent program to get you up to speed is here gobble it all up as soon as possible: www.dodgerslist.com/healingindex.htmWe need to know how many times a day you are to give 5mg of prednisone. And whether it is written when to taper off (lower the dose). These are the things you will need to attend to: 1. If you are see any hint of pain (holding head high or low, not wanting to bear weight on her leg, shivering, yelpig), get with the vet asap Today. Ask for methocarbamol for the pain often stemming from muscle pain. Find out the range of hours of tramadol you may give AND the range of dose in mg you may give. Often if not given at least 3x a day it will not control the pain from a disc episode. With the weekend coming up you want to know all your options for pain relieve when vets are not open, just the expensive ER vets. 2. You will want to do all the extra things that a neck disc needs help with: www.dodgerslist.com/literature/cervical.htm3. You most definately WANT a stomach protector on board today. Phrase the question to your vet in this particular way: " is there any medical reason my dog may not to take Pepcid AC?" If there is no reason, we follow vets who are proactive in protecting the stomach by giving doxies 5MG Pepcid AC (generic name is Famotidine) 30 mins prior to steroid. We ask that all members read about each med their dog is on or may take as a safety measure. This directory is in alpha order: www.marvistavet.com/html/pharmacy_center.html4. Has the diarrhea all cleared up... is she off Flagl? 5. Can you please confirm if she has bladder control. That means you are not finding any urine leaks in her bedding nor does she leak on you when lifted up? Bladder control is proved when they can sniff an old pee spot in the grass and then release urine. So let us know you have Pepcid AC on board, about bladder control, any pain issues and of course that you are doing 100% STRICT crate rest 24/7 only out at potty times for the remainder of the 8 weeks. Hang in there, as soon as Bella is out of pain, she can get on with the business of healing her disc and things will go a lot smoother for you too. |
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. So which is better to use Steriods or NSAID? You cant use both right? My concern is the vet gave her the Novac then Tramadol and the article said to wait between using them and we did NOT. Also in the article it has if she was holding her leg up it had (nerve root signature) what does that mean? As I'm sure you can tell I am a total basket case. I have moved to Miami and now have a vet that I have never used. I loved my vet in Georgia and would feel fine with him but this one is doing things different than I'm used to and I am worried to death right now. Any help you can give I would forever be grateful for. I'm just concerned that he does not have her on any anti-inflammatories but they said that the Tramadol had them in it and that would be fine. Is that right? It seems like she should have a pain medicine AND a Anti-inflammatory. 
