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Post by Loreen & VanGogh on Mar 29, 2016 13:57:11 GMT -7
Hi there, my name is Loreen and my dog's name is vanGogh, he's a Cardigan Corgi. We're in Traverse City, MI USA
We received a diagnosis of ivdd a couple of weeks ago when we switched vets. He is a general DVM, CVCP, CVA
The date we initially visited a vet was April 21st, 2016 when we first noticed that vanGogh was hunched over and in pain. We began with conservative treatment. 1st week was NSAID, that didn't work, then we began 20 mg Prednisone for 3 weeks and have been tapering off. We saw some improvement but it was recommended that we pursue acupuncture so, we switched vets to one that does both Western and Eastern medicine.
The first vet did NOT diagnose ivdd, I found information online and thought that might be his issue. So I restricted his movement and kept him on a leash for bathroom breaks with very limited movement. But we did not do strict crate rest at that time (we just didn't know). The 2nd vet we visited for the 1st time on March 18, 2016 - we began acupuncture and he diagnosed vanGogh with ivdd. He had us begin weaning him OFF of Prednisone (we did 5 mg/day for 7 days, 5 mg/day every other day for 3 doses and then were going to go to every 3rd day) and suggested we begin taking him on walks to improve his muscle strength. Needless to say that has not worked and now our pup is once again in pain.
CRATE REST: due to the advice of a dear friend we put vanGogh on strict crate rest beginning on Sunday the 27th of March, 2016.
He is 26.5 pounds and his current medicine is: Prednisone [as of 3/29]:- 5mg 2x/day for ? days, then taper (this is because he has been on 5 mg every other day and still experiencing terrible pain today so the vet upped the dose back to 5mg 2x day) Tramadol 50mg 3x/day Gabapentin 100 mg 3x/day KE Quick River 1 tablet 3x/day (not sure of the mgs) KE Bupleurum & Kudzu Clearing 1 tablet 3x/day (not sure of the mgs)
All bowel movements are currently normal and he is eating and drinking normally. He is able to release his bladder normally.
He can currently wobbly walk and can definitely wag his tail. He was showing signs of improvement over the last couple of weeks but with the walks and the reduction of Prednisone he is in more pain and moving much much less.
Today he has not stopped panting and is clearly uncomfortable (yesterday he was quite good) so, the vet added an extra dose of Tramadol & Gabapentin for today and then upped the Prednisone from 5mg every other day to 5 mg 2x/day.
Looking into Pepcid or something though we've NOT had him on anything with the Prednisone, he does get the Prednisone WITH his meals.
Thank you for all the wonderful information you've provided here!
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Post by Romy & Frankie on Mar 29, 2016 14:39:02 GMT -7
Hi Loreen and welcome to Dodgerslist. Everyone here has a dog with IVDD so you have come to the right place. The first thing to know is that it IS in the cards for your dog to get back to enjoying life whether immediately walking during the short 8 weeks of conservative treatment it will take a disc to heal or waiting on more nerve repair - IVDD is not a death sentence. Find out why that is true: www.dodgerslist.com/index/SDUNCANquality.htm ☐ Let us know you are on the same page about crate rest. The hallmark component of conservative treatment is the crate rest part. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm STRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times. Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! www.dodgerslist.com/literature/slingwalk.jpgYou mention that vanGogh is still in pain. Is that after the vet added the extra Tramadol and Gabapentin? If the pain meds are right full pain relief is expected in 1 hour and stays that way dose to dose Is van Gogh now on pred 5 mg 2x/day. Is the Tramadol 50mg 3x/day and Gabapentin 100 mg 3x/day now? Sometimes the severe pain of IVDD takes three meds to get pain under control. Tramadol and Gabapentin that you are using and Methocarbamol which treats muscle spasms stemming from aggravated muscles due to nerve trauma related to the spinal cord inflammation. If vanGogh's pain is still not under control, advocate for the addition of Methocarbamol. If he is still in pain let the vet know about it right away. Pain will only slow the healing process. It is very important that vanGogh has his stomach protected from GI tract damage by taking Pepcid AC. Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog not take Pepcid?" If the answer is no, the usual dose during a disc episode of Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. Give the anti-inflammatory with a meal as added protection. www.1800petmeds.com/Famotidine-prod11171.html "There is medicine and there is healing. Healing requires rest and comfort, and all patients should be kept as comfortable as possible. Studies have shown a correlation between less pain and faster recovery from illness, surgery, or injury." Barak Benaryeh, DVM, DABVP. Identifying Pain in Geriatric Patients. Veterinary Team Brief. NOV/Dec 2015. ☐ Why Chiropractic is not recommended for pain for an IVDD dog www.dodgerslist.com/literature/chiropractic.htmVanGogh's panting may be an indicator of pain but if you are not seeing any of the other signs of pain such as shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, can't get comfortable, tight tense tummy it may be a temporary side effect of the pred he is taking. A fan near the recovery suite but not pointed at him may help him feel more comfortable. Is it the same vet that prescribed the herbs as prescribed the other meds? I ask to make sure there would be no negative interactions with the other medications. Healing thoughts for Van Gogh.
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PaulaM
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Post by PaulaM on Mar 30, 2016 11:23:10 GMT -7
Loreen, I'm so sorry you have not been able to find a vet knowledgeable about IVDD. Everything pre 3/27 has been most unfortunatley negated: meds and the 8 weeks to rest to allow the disc to heal. In fact, lack of true conservative treatment has caused damage to VanGogh. More at the end of this post how you can step up to take the lead in his care with the right IVDD health care professionals you hire. There is still hope though and good hope that VanGogh can get his disc healed and be able to do that without pain. Following Romy's excellent detail and ideas on how crate rest under conservative treatment works will play an instrumental role. Let us know you are doing the 100% STRICT crate rest 24/7 only out at potty times for 8 weeks The meds prescribed are concerning for two reasons. 1) If pain is still not in control with Tramadol 50mgs 3x/day + Gabapentin 100mgs 3x/day, then the pain meds are not yet right for a 26.5 pound dog. IF there has still been pain after an hour of the new med dose or pain when moving such as at potty time, then ----- Advocate for the med that works on the specific pain of muscle contractions: methocarbamol to be added. Where to read more so you know why you are advocating for this med: to be Rx 3x/day MarVista Vet Drug Directory: www.marvistavet.com/pharmacy-center.pml----- Advocate for Tramadol at the appropriate high dose level than the low 50 mgs 3x/day. The info below is not for you to self prescribe but to be able to bring knowledge to the table to discuss/advocate for VanGogh. We all are laymen, not veterianians and do not know all of Van's health issues, contraindications with other meds, etc. that his vet would know. The usual in controlling pain is to Rx at the higher end of the mg range AND promptly every 8 hours Veterinary pharmacologist Bruce KuKanich, DVM, PhD, DACVCP: "Tramadol is rapidly eliminated from dogs after oral administration. Recent studies are suggestive the bioavailability of tramadol in dogs is lower than originally determined and the dose of tramadol needs to be increased with dosagesfrom 5 - 10 mg/kg PO q 8-12 hours in dogs to maintain similar plasma drug concentrations as those in humans." New developments in opioids: old drugs and some future directions (Proceedings)" DVM360. Nov 01, 2009 By Butch KuKanich, DVM, PhD, DACVCP 2) Use of Chinese herbs are a concern. I was not familiar with the Chinese Rx's so spent time in looking up each ingredient. Chinese Herbs are composed of many herbs in one bottle/pill, meaning you will need to Google each one to familiarize yourself on what your dog is taking. There can be possible negative reactions between prescription meds and Chinese herbs. Very experienced holistic vets will be hesitant to prescribe Chinese herbs when conventional medication are already in use (Prednisone, Tramadol, Gabapentin). The reason is there is no assurance there would not be any interactions with the other medications that could make your dog sick or worse. All drugs are poisons, all poisons are drugs whether the drugs is from a "natural" herb. Chinese Rx: Quick River: Processed Sichuan aconite main root Jiang huang - Turmeric rhizome Mo yao - " Aconite root is a deadly poison- Herbs containing aconitine are toxic to the nervous system. Aconitine excites the vagus nerve and central nervous system first, and then leads to successive inhibition, and finally death because of paralysis" www.tcvm.com/doc/TCVMNews2010SummerR.pdf "Based on laboratory and animal studies, turmeric may inhibit platelets in the blood and increase the risk of bleeding caused by other drugs. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve® ). " Prednisone causes extra stomach acids and often carry the adverse side effect of bleeding ulcers when the stomach is not protected with Pepcid AC (famotidine). So Loreen, IF bleeding ulcers were to develop with use of Prednisone, who wants a drug/herb in the system that inhibits bleeding? Chinese Rx: KE Bupleurum & Kudzu ClearingGan Cao (chinese licorice root) Licorice may increase the adverse effects associated with corticosteroids such as prednisolone and monoamine oxidase inhibitors such as isocarboxazid (Marplan®), phenelzine (Nardil®), or tranylcypromine (Parnate®). Agents acting on serotonin may also interact with licorice. Loreen, as you can read at the Mar Vista Drug directory entry for Tramadol: "TRAMADOL is not compatible with other psychoactive drugs such as serotonin reuptake inhibitors .."
Not all vets know every detail about every disease. Some vets are new to IVDD. But you can very quickly get up to speed on just one disease that is very significant to you and Van Gogh. This page was especially designed for the quick intro necessary in the first days of learning conservative treatment. When pain and meds are right and VanGogh is in comfort inside his recovery suite with 100% STRICT crate rest 24/7 only out at potty times for 8 weeks, then do pursue the rest of your "IVDD 101 readings" to be the IVDD savvy pet parent VanGogh will depend on during this disc episode and living with you many happy years ahead. This is the page to bookmark and come back to, start with the gold button on "Conservative Treatment first: www.dodgerslist.com/healingindex.htmLet us know you have Pepcid AC (Famotidine) on board and that pain is fully in control today.
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Post by Loreen & VanGogh on Mar 31, 2016 14:23:35 GMT -7
Hi Paula and Romy & Frankie, thank you so much for your response and your guidance.
First, and most importantly, vanGogh's pain is under control with the current meds (Prednisone 5mg 2x/day, Tramadol, Gabapentin, KE Quick River & KE Bupleurum & Kudzu). The vet who has prescribed these meds is first off VERY responsive and was VERY concerned about his pain level and urgent to ensure we had it under control as soon as possible. Responded to me within 5 minutes while on his day off. We got the pain under control within a couple of hours.
As far as the interactions of the medications the current vet was a Western vet for 25 years first before spending 10 years learning Eastern medicine and now he integrates both. He prescribed the herbs because those are two that he said CAN be used with the Prednisone without concern of adverse reactions. I believe that methocarbamol is what the vet was suggesting to us at our last visit however, I'm not certain on that so please don't quote me, I will ask him again. He wanted to wean vanGogh OFF of Prednisone before including that in the regime. I know that he is very concerned about the ongoing use of Prednisone due to its muscle wasting and that it blocks healing of the nerves.
We meet with him tomorrow (Friday, April 1, 2016) and will ask further questions about his pain management and drug interactions. I will also ask about the Pepcid which, we now have on hand.
As I stated in my first post above, we have had vanGogh on crate rest since March 27, 2016. He is carried otherwise and takes limited steps on a short lead (6 ft) to go potty. Prior to that I had taken it upon myself to restrict his movements for the first several weeks (no couch, no laps, no bed time, no walking) and only allowed walking AFTER the 2nd vet recommended it, that went on for a week. In fairness to the 2nd vet (our current vet) when he first saw vanGogh it was nearly 6 weeks after the initial incident/vet visit and he was in no pain, we thought he was on the mend and it was time to wean OFF the Prednisone.
Will send you updates after our visit tomorrow.
Thank you again for your concern and guidance. We appreciate it!
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Post by Romy & Frankie on Mar 31, 2016 14:59:10 GMT -7
I am glad that vanGogh's pain is under control. It is great that your vet is so responsive.
I understand why the vet wants to wean vanGogh off steroids. A dog should not be on steroids one minute more than necessary. When the vet thinks that the swelling in the spinal cord that is causing the pain is gone he will start the taper. To have a clear picture on a steroid taper, pain meds are usually also stopped. The owner's job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. Immediate feedback to the vet about any pain is necessary.
The Rule of thumb for this is:
pain = swelling = more time on anti-inflammatory, pain meds and Pepcid AC needed.
Often a "plan B" with your vet is decided on when a taper is going on so that if the pain happens at night, weekends or holidays when the vet is not open, the owner knows what action to take, what meds to give til the vet can be contacted again. A "plan B" can save an expensive ER trip.
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Post by Loreen & VanGogh on Apr 1, 2016 15:36:52 GMT -7
Hi Romy & Frankie! Thank you!
We went back today and we did add in the Pepcid AC. We are also going to try to wean off the steroids again and watch VERY CLOSELY for pain. If we experience pain during the taper period there is a plan to alternate with NSAID. In addition, we have a direct cell phone number for the vet and he has asked us to call him any time 24 hours IF we find that vanGogh is experiencing pain.
Thank you SO MUCH for the Plan B idea!
For right now we are going to continue our CRATE REST with limited walking only for potty on the lead and then we visit next week again for continued acupuncture.
vanGogh did very well at his visit today and has not been experiencing pain since his episode on Tuesday (March 29, 2016). His acupuncture session went very well and he had some more nerve function than last week.
We're cautiously plugging along.
Thank you so much for your responses, the support and the WONDERFUL information!
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PaulaM
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Post by PaulaM on Apr 1, 2016 15:54:37 GMT -7
Loreen, you will want to verify you heard correctly. To alternate between a steroid and a NSAID would be an extremely a dangerous practice... possibly deadly for vanGogh. All NSAID packages warn against using NSAIDs and steroid together. Vets who practice safe medicine look for a 4-7 day washout from the end of a steroid til the start of a NSAID and visa versa. Do let us know the details of the taper and what the exact name of the med to be alternated is. Dr. Davidow, DVM, DACVECC explains what is written in many veterinary textbooks about the dangers: "Steroids should never be given concurrently with a non-steroidal anti-inflammatory. Over the years, I have been involved in several cases of both bleeding and also perforated gastric ulcers, some of which required transfusions and/or surgery. Many non-steroidal medications have a very narrow therapeutic dose and the addition of even one dose of steroids can lead to severe intestinal consequences. It is VERY important to look carefully at medication history before starting either a steroid or a NSAID." "Steroid Rules to Live By" Acces Update. Spring 2014. www.criticalcarevets.com/sites/default/files/RDVM_spring_woot.pdf
What dose of Pepcid AC in mgs and are you to give it every 12 hours?
What date is the prednisone taper to start?
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Post by Loreen & VanGogh on Apr 4, 2016 10:25:32 GMT -7
Hi Paula,
We are giving him [26.5 lbs Prednisone as of 3/29:- 5mg 2x/day for 4 days, then taper Tramadol 50mg 3x/day Gabapentin 100 mg 3x/day KE Quick River 1 tablet 3x/day KE Bupleurum & Kudzu Clearing 1 tablet 3x/day] Pepcid AC 10 mg once a day.
The taper schedule for the steroids (Prednisone) has been: 4 days at 2x day - 5 mg, 4 days at 1x/day - 5 mg, then every other day for 4 doses at 5 mg. We've been on the 1x/day for 3 days now... we will do the last daily 5mg dose tomorrow (April 5, 2016) and then begin the every other day (Thurs 4/7, Sat 4/9, Monday 4/11 and Wednesday 4/14). We have been watching very closely for signs of pain and do not have any at this point. Our next appointment for acupuncture is Monday 4/11. If any signs of pain appear we will contact the vet immediately.
The vet really wants vanGogh OFF of the steroids and feels it's critical to his being able to heal. He only suggested the NSAID IF vanGogh experiences pain when he is on the every other day portion of tapering OFF of steroids (and only [NSAID] for the off [steroid] days never both together at the same time). To be clear he doesn't want vanGogh on the NSAIDs either. (I don't think I phrased that well above - thank you for pointing it out). He agreed that the washout is ideal but our course of action will depend upon how vanGogh reacts to the reduction in his steroids. Ideally, we'd like to be healing with the Chinese herbs, acupuncture and laser therapy because both the NSAIDs and Steroids are delaying the healing process for him.
VanGogh is still on crate rest; walking minimally at potty times.
Fingers crossed that with his minimal activity we will be able to taper him off of the steroids this time without incident. Last time, the vet thought he was further along in his healing and we were taking him for walks and allowing him more movement. That is NOT the case this time.
Thank you again for your concern and your phenomenal help!!
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Marjorie
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Post by Marjorie on Apr 4, 2016 13:01:06 GMT -7
I'm very glad to hear that there have not yet been any signs of pain returning during the taper of the Prednisone, especially in light of the vet's very dangerous plan should pain return. Switching back and forth from a NSAID to a steroid is indeed a very dangerous practice.
You mentioned that both the NSAIDs and steroids are delaying the healing process. He's only been on the steroid at this point, is that correct?
Steroids and NSAIDs will not cause a delay in the healing process. Their purpose during an IVDD episode is to quickly get the swelling that's pressing on the nerves of the spine down. It's that swelling/pressure that causes the pain and causes nerve damage. I, too, prefer using natural and homeopathic remedies when I can with my Jeremy. But when he has an IVDD episode and his spine is involved, I gladly allow the vet to pull out the big guns of steroids and aggressive pain meds until the danger of nerve damage is past. Van Gogh hasn't been on the steroid for that long a period of time. Swelling can take 7-30 days to resolve and often times a steroid is necessary during that period of time.
That's what is needed to get the swelling down. As for the damaged disc, it's the 8 weeks of 100% 24/7 strict crate rest for 8 weeks that will heal the damaged disc and allow for the formation of scar tissue. The steroids and pain meds do not heal the damaged disc - only restricted movement does that.
What is very important is to get Pepcid AC on board to protect Van Gogh against the side effects of the Prednisone. The vet is concerned about Van Gogh being on the Prednisone but is doing nothing to protect his GI tract. Please speak to the vet today about adding Pepcid AC 5 mg 30 mins. before the Prednisone and then every 12 hours thereafter for as long as Van Gogh is on the Prednisone (2x/day).
Also the vet has not tapered or stopped the pain meds. Those pain meds are working to mask any sign of pain that Van Gogh may have during this taper of the Prednisone. Keeping Van Gogh on the pain meds during the taper makes it very difficult for you to determine whether there is still swelling and still a need for the Prednisone since you can't tell whether there's pain or not since pain meds are being given. Please speak to the vet today about stopping the pain meds or at least tapering them so a true test for pain can be made. If the pain meds are stopped and no pain returns during the complete taper of the Prednisone, then there would be no further need of any meds.
Prayers for a pain-free taper off of all meds for Van Gogh. Please let us know what the vet says after speaking to him today about the above issues.
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Post by Loreen & VanGogh on Apr 5, 2016 8:31:47 GMT -7
Hi Marjorie,
VanGogh has been on Steroids since February 18th of 2016, so 7 weeks. And was on NSAID for a week prior to that.
According to my vet, who is far more expert than I on this subject, the steroids & NSAIDs decrease the blood flow to the damaged area which delays healing of the nerves. In addition, it causes muscle wasting.
Due to vanGogh experiencing lots of muscle wasting and already being on steroids for such a long time, our vet is urgently trying to get him off of steroids. It does not mean he doesn't want to try other therapies to help. He does not want vanGogh to be in pain or to experience swelling, thus we have 2 Chinese herbs (both anti-inflammatories) and we are doing acupuncture and laser therapy. And of course monitoring things very closely as we try to taper off steroids.
I understand the healing process as described here and we have him on crate rest with minimal walking at potty times on a lead. Our vet is also on board with minimal activity.
The vet prescribed Pepcid AC and we have had him on that for several days now.(1x/day and Prednisone is only 1x/day, we begin every other day taper tomorrow) So, I do believe he has a concern for vanGogh's GI tract.
I am very fortunate that the vet we have now is very available to us, responds VERY quickly and has indulged me in every single conversation about my concerns and all of the concerns that you folks have so graciously shared with me here in this thread. He listens and has been very consultative and collaborative. I appreciate him so much for that as that has NOT always been the case with other vets.
I believe that our last pain incident was due to vanGogh having too much movement and freedom as we had been taking him on walks. He's been on crate rest since the 27th of March and though I realize that is not a long time, we are hopeful that it is long enough that if we taper off his steroids he will not experience the swelling this time. We will continue the crate rest of course and acupuncture and reassess his medications as we go along. Last time our pain incident happened after 2 doses of the every other day steroid taper. He will have his first day off of steroids since that incident tomorrow and we will keep close watch for any changes.
Thank you so so much for your guidance! You guys are so quick to respond and helpful. It's truly appreciated! I've learned so much already and feel that I have the information I need to be able to help my dog to heal AND to have productive, collaborative conversations with my vet about his care!
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PaulaM
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Post by PaulaM on Apr 5, 2016 19:30:11 GMT -7
We've got our fingers cross there will be no sign of pain on the taper of pred. The taper is a test for pain. Which does your vet want re: pain-masking pain meds to have a true test: --- stop the tramadol and gabapentin --- or the backing of of tramadol and gabapentin
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Post by Loreen & VanGogh on Apr 6, 2016 13:24:47 GMT -7
Hi Paula,
I too have fingers crossed that we taper off Prednisone without incident.
I'm not sure I understand your question about the pain meds. I'll do my best to address it. We recently had a flare up and pain with vanGogh, we do not want that again. We think that is was due to too much movement and freedom on his part. Now we've altered course to crate rest, hoping that will help with his healing. So, there is a thought that he is not done healing yet and we may have additional incidents, BUT... the vet does not want to address that with additional steroids since vanGogh has been on them over 7 weeks going on his 8th week now. If we have to address swelling and pain, the vet would like to do it with safer meds however, as we know many meds can NOT be used in conjunction with steroids. So, ideally we get him off of steroids in a safe way so that IF we do have continued pain/swelling, we are able to address it with a new protocol of medication. A delicate process as we do not want him to be in pain at all.
I hope that addresses what you are asking here. Today (4/6/16) is the first day of our 2nd attempt at the every other day taper off the steroids. So far, he's doing beautifully. But I believe the true test will come later as last time it wasn't until the 2nd day without steroids that he experienced pain... again, we are NOT sure why he experienced pain and can only surmise that it was due to too much movement?
Thank you Paula!
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PaulaM
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Post by PaulaM on Apr 6, 2016 15:23:10 GMT -7
The test for pain taper is usually done in a speedy manner. If there still swelling in the cord, then the steroid needs to be back on board a bit longer to get it all resolved. Having pain meds on board during a taper, does not let you know the truth...is the swelling gone or just being masked by pain meds.
To change to a different anti-inflammatory the NSAID require a 4-7 day washout. No washout is double jeopardy to the GI tract...a dangerous sitation that could turn deadly. So as long as vanGogh is on pred, and IF, if he should still have some cord swelling, staying the course with pred is the wiser idea.
The safety in using meds is two fold. A vet who uses them in a safe manner, takes a blood test to verify the health of using any anti-inflammatory med PLUS an owner who has read up on each med to be aware adverse side effects to monitor for.
How long is too long to use a steroid? Carlo Vitale, DVM, Dipl. ACVD: "But what constitutes long-term therapy? More than two months? More than six months? A year? No one really knows, but I would estimate more than three months."
We've got our fingers crossed the pred taper will go to completion, the pain meds will be stopped and you will have an answer that all spinal cord swelling is gone. That means no meds at all are needed, just crate rest to let the disc finish healing.
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Post by Loreen & VanGogh on Apr 7, 2016 9:29:26 GMT -7
Hi Paula,
We are hoping for the same! Will keep you all updated here as we progress.
So far, we're doing good. We still have a week to go on the every other day taper off the steroids. We have a check up and acupuncture with the vet on Monday, 4/11/16 and barring any incident before that time, we will talk about next steps with his treatment/meds going forward at that point.
Our vet is not trying to taper vanGogh off of everything right now, just taper him off the steroids as he is concerned about the ramifications for vanGogh.
Because we didn't know what to expect and our first vet was not familiar with protocols for ivdd, we did not have the best start to our healing process with vanGogh... we hadn't limited his movements as much, he was not on crate rest and our 2nd vet wasn't introduced until vanGogh was several weeks along in the process and thought that he was further along in his healing. We had a setback, we reset our focus and our treatment and now hope that we are on track to provide vanGogh with the best possible chance for healing.
Thank you again for your concern, your advice and the wonderful guidance.
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Post by Loreen & VanGogh on Apr 12, 2016 10:15:14 GMT -7
Update after our visit to the vet yesterday afternoon (4/11/16). vanGogh is doing well, he's walking a bit straighter and we've had no pain incidents while tapering off of the steroids. We have 1 final dose of steroids left, to be administered tomorrow, 4/13/16 (5mg/Prednisone - which he has been on every other day since 4/6/16).
Our plan moving forward is to transition him to NSAIDs, specifically Medicam beginning this Friday, 4/15/16 and administering it 1x/day going forward. We will then begin to taper down the pain meds (tramadol and gabapentin) beginning on Monday, 4/18/16, going from 3x/day down to 2x/day and again monitor closely for pain. The vet is keeping him on the Pepcid AC 1x/day going forward.
The vet feels that we will likely be on the Medicam for another month but hope to be able to taper off of that and the pain meds by the end of the next 4 weeks and then just maintain the Chinese Herbs and acupuncture moving forward.
We have been able to increase the days between acupuncture to 10 now and he's still doing well.
vanGogh remains on crate rest, eating and drinking well only walking at potty times.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Apr 12, 2016 14:25:19 GMT -7
There are no safe medicines. NSAIDs also carry dangerous side effects. Now is the time to fully complete the test for pain. Stop the pain meds to give conclusive proof IF any meds at all are needed. Vets who practice safe medicine do not want a dog on a NSAID nor on a steroid if they are not needed. There is no way to tell when these meds are needed until a complete test for pain has been accomplished: Stopping of the steroid and stopping of the pain meds. If you at home see pain then the vet knows an anti-inflammatory is still needed. It is very helpful to have an idea how steroids and how NSAID work with a disc episode. This page is a good refresher so you can advocate for not having meds on board when they are not needed. Using meds when there is no job for them to work on (painful inflammation/swelling) only subjects vanGogh to all the danger side effects. Very useful information owners need to know about NSAIDs that your vet may not have gone over with you: www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm196295.htm
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