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Post by Norma & Cali on Jul 22, 2017 5:04:58 GMT -7
Hi all - I am going to be scouring this list for info over the weekend. Here's some info on my dog: Cali Sunshine, English yellow lab, 7 years old. She weighs about 68 lbs- down from 76. Her story, in a nutshell -- on April 24 she was chasing a rabbit in the backyard, she chased it under the deck, but it's a low deck, and had a head on collision. She would scream in pain, and we brought her to the vet, who immediately knew it was cervical. He put her on strict cage rest, and two weeks of Prednisone, as well as Tramadol, and famotidine. After 2 weeks, no better, so he put her on 6 weeks of rest, more tramadol, and more prednisone. She was a tiny bit better, but wouldn't lift her head -- at this point, mid June, we consulted with a vet neurologist/pain specialist. They changed her meds to Gabapentin, only, 300 mg. 3 times a day. At first she seemed much better, but was soon back to her pain -- she wouldn't lift her head.
[68 lbs
Prednisone as of 4/24: STOPPED
famotidine STOPPED
Tramadol STOPPED
Gabapentin 300mgs 3x/day]
They then recommended MRI - which she had on Thursday of this week, and she was found to have a bulging cervical disc, and surgery will be on Monday. Apparently it is compressing the spinal column, and the vet described it as what should look like a circle looks like a comma -- make sense? At this point, she is lifting her head a little more, so the new med seems to help, however, the specialist said that her discs are degenerative, and that this impact accident only made happen quicker what was going to happen anyways. Am I correct in the thoughts that labs don't usually get this? She is eating and drinking ok, actually, very well -- poops are ok, she is having some poop and urine accidents - she shifts position a lot, and breathes very heavy. She walks fine, her issue is cervical, so with her it is that she won't lift her head, and looks so darn sad! She wags her tail, and uses her eyes to look at us, rather than her head-- if this makes sense... she moves her eyes, not her head. I will post some pics in a bit -- I have one that is so funny of her looking up at us - guaranteed to make you smile. Thanks for letting me in this group!! Norma Hartwell
I will send you another pic, from this am, before her surgery. I have had her under our local vets care, and now a board certified pain specialist/neurologist, who is the best of the best, in our area. I am by no means an expert, being very new to the ivdd journey, but i have done a ton of research. This pain specialist said recent studies have shown Tramadol is not an optimal pain med for dogs, it more makes them dopey. Any thoughts? She is also having laser, and hyperbaric oxygen chamber for wound healing. I will know more tomorrow. Thanks for your care and input. Norma
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jul 22, 2017 6:02:53 GMT -7
Welcome to Dodgerslist, Norma. First thing to know is that it IS in the cards for your dog to get back to enjoying life whether immediately walking after surgery or waiting on more nerve repair - IVDD is not a death sentence. Find out why that is true: www.dodgerslist.com/index/SDUNCANquality.htm There is no reason for Cali to remain in pain until Monday. The vets have allowed her to be in pain all these weeks and that is just unacceptable. Neck injuries can be more painful than back injuries and usually need three pain meds to address the pain. Tramadol for general pain, Gabapentin for nerve pain and Methocarbamol for muscle spasm pain. Her pain meds should be such that she is in comfort and able to lift her head without pain. Please strongly advocate for all three pain meds 3x/day TODAY to get Cali's pain under control. When the pain meds are right, her pain should be completely under control within one hour after taking the new course of meds and should remain completely under control from one dose of meds to the next. Is the surgeon a general practice DVM or a specialist (ACVIM neurology or ACVS ortho)? Any dog can be born with IVDD though it's usually dogs with short stubby legs and long backs. Did the vet give you a specific diagnosis of IVDD or could the injury have been caused by the head-on collision? If it's IVDD, please know that it's a life long disease so you'll need to become educated and learn all you can to fight this disease. Here's a good place to start your education: www.dodgerslist.com/healingindex.htmPrayers for a successful surgery on Monday. Please keep us updated and let us know what prescriptions are prescribed at discharge and what directions are given as to physical therapy and crate rest. |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Jul 23, 2017 9:39:21 GMT -7
Norma, the picture you sent this morning and the list of pain signs in red in your post are an emergency to deal with today at ER. Waiting til Monday is excrudtiating pain for Cali that need not be as she waits for surgery. Call, go do what you can to get tramadol back on board with the gabapentin. With neck discs much of the pain is of muscle contractions. So a 3rd pain med should also be on board.
PLEASE, let us know you have had success in getting pain relief for poor Cali. What the meds are, the dose in mgs and how often you give them. For full pain relief typically those meds I mentioned are given every 8 hours.
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Post by Norma & Cali on Jul 24, 2017 20:35:07 GMT -7
Hi Paula, Cali had her surgery this morning [7/24]. She seemed much more comfortable on the Gallipant. Even lifted her head on way to neurologist this am. Any advice on what you think she should come home on?
[68 lbs
Galilipant ?
famotidine STOPPED
Gabapentin? 300mgs 3x/day]
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Post by Pauliana on Jul 24, 2017 22:25:04 GMT -7
Hi Norma, Glad to hear that Cali's surgery was this morning. I hope she has a wonderful recovery. Are you to continue the 300mg Gabapentin 3x/day? What is the dosage of the Galliprant and how many times a day is it to be given? I know it is often used for arthritis and is one of the newer NSAIDs that targets pain as well as inflammation.. The treatments for a disc episode are the same no matter whether it is a cervical disc or another disc lower down in the spine which is causing the problem: conservative treatment or surgery. A disc problem in the neck can be more painful and may take longer to resolve because a dog moves its head with almost all actions and when any other part of the body moves. That constant movement means that healing can take longer because the neck doesn't get the rest to allow the disc uninterrupted healing. These are additional things you can do to help with a cervical disc problem during the 8 weeks of 100% STRICT crate rest 24/7 with conservative treatment: Make sure the medications are fully controlling pain from dose to dose with no break through in pain. Continued feedback to your vet is vitally important until the pain medications have been properly adjusted for your dog. There is no "one-size-fits-all" pain control. Signs of pain are holding the head in an unusual position...head held high or nose to the ground, shivering/trembling, not wanting to move much or moving gingerly, yelping, tight/tense stomach muscles, holding leg up flamingo style...not wanting to bear weight on the leg. These are the typical pain medications used to treat IVDD: 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. Gabapentin may be added to the mix for hard to control pain. Veterinarians are finding this medication works very well in combination with Tramadol. Raise food and water bowls to head height to avoid bending down to eat and drink. dodgerslist.com/literature/cratesupplies/bowlHLDR.jpgIf you feed kibble, moisten each meal with equal parts water and kibble and allow to hydrate in the fridge overnight. Then warm slightly in microwave, just to take the chill off, before serving. This will eliminate pain from crunching kibble. No chew treats or kongs during recovery. Chewing on those makes the head and neck move a lot and can deter healing and cause more pain. Let us know what the surgeon wants for crate rest and what his instructions are for PT. It can take 2 weeks for the surgical swelling to subside and by that time you should start to see the direction Cali's healing will take.. Feel better soon, Cali! |
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Post by Norma & Cali on Jul 25, 2017 17:48:29 GMT -7
Hi there, Cali is back home with us! They kept her one night. The galliprant (sorry, the typo in the other text was autocorrect) was 60 mg once a day. That is now discontinued, which annoys me a little, since it was $90 for 15 tabs, and we only needed 4...she had a ventral slot C6-7 surgery. She had a laser treatment, and a hyperbaric chamber treatment before coming home. Her meds are: Gabapentin, 600 mg tabs, 3 x daily; prednisone 10 mg tabs, 1 x daily, and amantadine, 100 mg caps, 1 x daily. Strict rest, for 2 weeks, room rest for 2 weeks,
[68 lbs
Galilipant as of 7/21 : 60mgs 1x/day stopped on 7/24
Prednisone as of 7/25: 10mgs 1x/day
famotidine STOPPED
Gabapentin 600mgs 3x/day
Amantidine 100 mgs 1x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Jul 26, 2017 7:51:44 GMT -7
Norma, it appears Cali has not had a 5-7 days washout from the NSAID Galliprant before use of the steroid prednsione. NOR has she had double stomach protection if there could not be a 5-7 day washout. PLEASE contact your surgeon, did he know she had had 4 days of Galliprant? Pepcid AC (famoditine) should be on board as well as the 2nd protector sucralfate. Please read the links so you know why you are advovating to protect the GI tract. You will read in the sucralfate link there is a timing with Pepcid AC and with food in order for it to form a protective gel coat. |
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Post by Norma & Cali on Jul 26, 2017 17:33:05 GMT -7
I have been reading how people carry their dog to go to the bathroom... any hints for the big ones? She's 66 lbs! She is walking as usual, but we are bringing her directly out, hasn't pooped yet, but is peeing fine, squatting to do so. You'd never know she had major surgery 48 hours ago.
Hi Paula, maybe no washout because she was only on it 4 days? I called about stomach meds, and they said they don't worry about it with bigger dogs, but I pushed, and got them to say 20 mg twice a day of fantidimone,(sp) and also got Trazodone started for anxiety while confined, 2x a day. In answer to your question, the Neuro prescribed the galliprant, and the prednisone both, 4 days apart. Thoughts?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Jul 26, 2017 17:51:20 GMT -7
Norma, with a dog who has had surgery and the offending disc material has been removed, then the dog can start some PT as soon as the surgeon directs. When a dog can walk often that PT will be the walk to and from the potty place. Of course, a slow, supervised with harness and leash walk.
What did your surgeon direct for PT and for how many weeks of crate rest which includes his directed PT? Some say 4 weeks and for other dogs it can be 6 or 8 weeks.
We have seen way too many serious GI tract issues when the typical of a 5-7 days washout is not done or if an emergency, then double stomach protection is not done. So we seriousy follow the vets who appreciate the damage that can be done. One dose is one dose and it takes 5-7 days for the body to process and get out of the system. Glad you adovocated for famotidine!!! Be watchful if sucralfate is needed due to begining red flag signs of not eating, vomit, loose stool.
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Post by Norma & Cali on Aug 25, 2017 5:17:51 GMT -7
Went for post op yesterday, 1st one. Surgeon wasn't happy... Cali put on a show where she kept her head low, I had to show surgeon a pic I took on way in where her head was up high. she gave her a laser treatment, and kept her on the same program for the next two weeks-- one room only, leashed walks for potty, same meds: 600 mg of gabapentin, 3 x a day, 20 mg prednisone, 1 x a day, 40 mg of pepcid, 2 x a day, and amantadine, 100 mg, 1 x a day. She goes thurs from 8-1, For rehab treatments. She's developed knuckling in rear right leg, that wasn't there pre-op. I feel this is a setback, but hopefully she's just slow to heal. Thoughts? Also, she's gained weight. She's up to 73 lbs,
[73lbs
✚new neuro knuckling post op
Prednisone 20mgs 1x/day
gabapentin 600mg 3x/day
Amantadine 100mgs 1x/day
Pepcid AC 40mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Aug 25, 2017 8:37:15 GMT -7
Norma, discuss with the surgeon what her thinking is.
~~ Is the new neuro diminishment happening post op, due to a possibly missed piece of disc material or a new tear/bulge cauisng the recent post-op knucklng.
It is possible to treat the missed piece or new tear/bulge by conservative treatment. Or sometimes the surgeon goes into removed what was missed. These are the decisions you and your vet will need to discuss together and make the best decision.
Did the vet say stop the PT should this be a new tear so that the disc can have a chance to heal, the spinal cord can have a chance to reduce the painful swollen state via Prednisone?
Did the vet feel this neck disc problem was a chronic one (aka Hansens II type of disc?)
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Post by Norma & Cali on Jan 1, 2018 6:45:29 GMT -7
My dog was doing wonderful, but for some reason the surgeon kept her on prednisone for 8 months...now she has Calcinosis cutis, terrible, as well as probable c ushings. Anyone else's pup experience this, any advice?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Jan 1, 2018 14:57:07 GMT -7
Norma, sorry we kinda lost touch with what happened with the post op knuckling. Is she now walking in good form? Any pain?
Prednisone does carry with it side effects. If there is a good reason for the pred, then it may be worth the risk of some side effects. Hard for us to just give a specific comment without you first filling us in on some things.
What is the reason the surgeon told you to keep Cali on prednisone for 8 months? What was the prednisone supposed to help?
What is the dose you have been giving for 8 months?
Have you had her on Pepcid AC all this time too?
Please list all meds that Cali is now on including the mgs for each dose and how often you give them.
How much does she weigh?
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Post by Norma & Cali on Jan 2, 2018 5:52:52 GMT -7
Hi Paula, the surgeon really didn't give good answers as to why. I asked her 3 times to taper, since back in Sept when her blood came back elevated for kidney issues, and surgeon said that would resolve after weaning. Ugh, hindsight. The knuckling resolved, and she's been doing excellent physically. This skin issue started about 3 weeks ago, I took her to the vet immediately, and she's seen 5 vets in 3 weeks, including the surgeon. It is absolutely heartbreaking how terrible this is. She's going to Boston this afternoon to see an internist. She is now on 5 mg every other day of pred, 1200 mg of Gabapentin, 100 mg of amantadine, 20 mg of pepcid, and 50 mg of benadryl. She just finished baytril and cephelexon. She's also taking 1 c fat free plain yogurt.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Jan 2, 2018 8:43:02 GMT -7
You might try to find a Forum that is dedicated to Cushings that might include discussion of Calcinosis cutis (CC)
Hope the Boston internist will get Cali on track having only the needed meds on board. Gabapentin and Amantadie are for the CC or left over since 8 months ago?
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