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Post by Diana & Sam on Jan 29, 2018 15:48:47 GMT -7
Diana's Sam 1/30/2018 conservative - NECK Hi, I am sorry I have not posted any updates, life has gotten in the way. I was going to post that Sam has been off all meds except metacam and acupuncture. Sam has been having, I don't know what to call it, short little episodes, that stop after some meds, he only needs one dose. I have given him 1 ml of Gabapentin, 1/4 tab of robaxin, and rest, he seems good. I haven't any idea what he might be doing. I was hoping he could graduate. thank you again for always being there and giving your time. [Moderator note, please do not edit 15 lbs New NECK disc episode on 1/26/2018 Crate rest as of 1/26 Metacam as of 1/26:for 4 days STOPPED on 1/30 Prednisone 3 day washout as of Sat 2/3: 5mgs 2x/day for ? days then taper to test for pain/neuro loss Tramadol 25mgs 3x/day STOPPED Gabapentin ?mgs/mL?: ?mgs 3x/day not STOPPED Robaxin (methocarbamol) 125 mgs 3x/day not STOPPED Pepcid AC 5mgs 2x/day]
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Jan 29, 2018 21:50:16 GMT -7
Diana, we are quite confused.
When did metacam start? What did the vet observe to make him prescribe it? Still taking Pepcid AC?
Did he have another disc episode after he should have graduated back Nov 8ish, 2017?
Describe what you you observe when you see an "episode" Neck, back, legs, pain??? What does the vet think it is?
Pleasse fill us in so we understand Sam's problem
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Post by Michelle & Clover on Jan 31, 2018 6:40:57 GMT -7
Hi Diana,
I wanted to chime in because this is exactly what happened to my girl Clover. When we went down to one 5mg of prednisone per day, Clover also started to have short painful episodes that would stop within an hour of administering pain meds. Her whole body would shake, tremble, and would tighten up. Unfortunately, these episodes continued to happen for a week on and off. When I took Clover to the vet, they stated that she had a relapse. I had to go back to the anti-inflammatory dose of two 5mg of pred per day and start my 8 weeks of crate rest over.
I was so disappointed...like you, I was worried about how long Clover had been on prednisone and I wanted her to graduate so badly. These darn neck discs just take so long to heal and I was so eager for Clover to get better. I thought the episodes were just small breakthru pain and part of healing but have learned that the inflammation was back and that the prednisone taper was over and it was time for the big guns again! Prednisone to be reinstated 2x/ day along with methocarbamol and gabapentin every 8 hours.
I hope Sam and Clover can get better this round. It's so sad to see them in pain.
Michelle
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Post by Diana & Sam on Feb 1, 2018 9:58:26 GMT -7
Michelle, thankyou that is exactly what seems to be going on with Sam. It seemed he was doing so well for November, December and most of January, no meds other than metacam. Then these little episodes of stiffness, trembling and pain. Sam was getting metacam 6 ml every 24 hrs, for arthritis. We saw the vet on Tuesday [1/30] , we have started Gabapentin 50 mg, Robaxin 125 mgs, he will start Predisone on Saturday, after he has been off of metacam for 3 days. I didn’t know what to think, one minute fine, next moment in pain and some meds he would be fine again. The neck is so different then the back.
[Moderator note, please do not edit 15 lbs New disc episode on 1/26/2018 Metacam on going for arthritis: STOPPED on 1/30 Prednisone after 3 day washout as of Sat 2/3: ?mgs ?x/day Gabapentin 50mgs ?x/day not STOPPED Robaxin (methocarbamol) 125 mgs 3x/day Pepcid AC 5mgs 2x/day]
Paula, i have never been very good at putting words to paper, explaining my thoughts. Can’t thank you all enough for patience, I hope this is a little clearer.
Thank you again Michelle, really appreciate your input.
Diana
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Post by Romy & Frankie on Feb 1, 2018 15:06:33 GMT -7
It seems the vet thinks that poor Sam has had a relapse. Am I correct in saying that? Unfortunately, this does sometimes happen.
Is the gabapentin and roboxin taking care of his pain? Just for your easy reference the signs of pain we look for are;- shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy, restless, can't find a comfortable position. Ears pinned back, arched back. Holding front or back leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky selves. If you are still seeing signs of pain, let the vet know right away so the pain meds can be adjusted.
A 3 day washout between the metacam and the pred is shorter than the 4-7 day washouts we usually see. Speak to your vet about using another stomach protector, Sucralfate, besides the Pepcid AC to double protect his stomach. Sucralfate gel coats like a bandaid any disruption to the stomach lining and starts the healing process while the Pepcid reduces stomach acid.
As Michelle mentioned, the 8 weeks of crate rest must restart from the point of the relapse. I know this is difficult to hear when you were almost finished. But it is the best way to heal the disk and prevent further damage.
Healing thoughts for Sam.
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Post by Julie & Perry on Feb 1, 2018 16:00:40 GMT -7
I know it's hard to start over on crate rest!
Last year my Nala ended one crate rest and two weeks later started another.
The good news is she's had a year now with no episodes.
Hang in there. Stay strong and positive for Sam and take care of yourself too.
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PaulaM
Moderator. ![*](//storage.proboards.com/forum/images/stars/star_magenta.png) ![*](//storage.proboards.com/forum/images/stars/star_magenta.png)
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Feb 1, 2018 19:05:16 GMT -7
Diana, the reason vets usually switch to the most powerful of the anti-inflammatory classes, a steroid is due to neuro loss. You are reporting pain only. Does Sam show neuro loss: drag his nails, knuckle front or back paws under? With the stop of metacam, Sam has nothing to be working on the a painful swollen spinal cord. Discuss with the vet about resuming Metacam tomorrow and your doing 100% STRICT rest 24/7 for the full 8 weeks, only out for a very, very few footsteps at potty time that you had not been doing. STRICT crate at first hint of a disc episode is to keep the disc from further damage and potential for severe damage to the spinal cord. With no anti-inflammatory on board, is his pain fully in control dose to dose all day and nite long? If not in addition to finding out about continuing on with Metacam so there is no need of a washout advocate for a more aggressive pain approach, three meds each working on a different kind of pain and Rx'd for every 8 hours (Tramaold, Gabapentin to go with the Robaxin every 8 hours. How many times a day are you giving Gabapentin 50 mgs? Are you continuing with Pepcid AC 5mgs 2x/day?Since the Sept disc episode likely had that disc enough time to heal, then what you are seeing and the end of January could be the same disc or another disc. During the 8 weeks it takes a disc to heal, if too much movement is alllowed, then the early healing disc is likely to have a relapse, a disruption of the formation of disc scar tissue. Where does the vet believe this current disc episode is in the neck or the back?If it is a neck disc again, these are the extra things you can do at home: www.dodgerslist.com/literature/cervical.htm
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Post by Diana & Sam on Feb 3, 2018 17:03:53 GMT -7
Sam's ,current episode is in his neck, it started with Sam hanging his head, walking stiffly and wobbling, very painful on Thursday January 26th. it has not been as severe as the first neck episode. I always have meds on hand, so I started him on Gabapentin 50 msg 2x/day, 125 mg robaxin 2x/day, and he was taking at the time metacalm 1 ml in a 24 hr period. If pain broke thru I would add Tramadol 25 mg if needed, Pepcid 5 mg 2x/day. Controlled his pain.
We saw our vet on Tuesday, January 30, jointly we decided to stop metacalm and start prednisone. Sam is still showing signs of stiffness, humped back, nose to the floor. he is on crate rest has been since the 26th. His meds are currently prednisone 5mg 2x/day, Gabapentin 1 ml/50mg 3x/day, Tramadol 25 mg 3x/day, Robaxin 125mg 3x/day, Pepcid 5 msg 2x/mg. This seems to controlling his pain. He is eating and drinking, nothing like the first time. Continuing with acupuncture.
[Moderator note, please do not edit 15 lbs New NECK disc episode on 1/26/2018 Crate rest as of 1/26 Metacam as of 1/26:for 4 days STOPPED on 1/30 Prednisone 3 day washout as of Sat 2/3: 5mgs 2x/day for ? days then taper to test for pain/neuro loss Gabapentin 50mgs 3x/day Tramadol 25mgs 3x/day Robaxin (methocarbamol) 125 mgs 3x/day Pepcid AC 5mgs 2x/day]
Thank you for all the information, support and positive thoughts.
What is the thought on how many is too many episodes? to treat conservatively and to start thinking of treating with surgery? Sam has had 5 episodes over the last 4.5 years, 3 spine, paralysis all 3 times, he never lost bowel or bladder control. any thoughts about this would be so appreciated.
Diana
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Post by Julie & Perry on Feb 3, 2018 20:22:27 GMT -7
Unfortunately some dogs, like Sam and my Nala, are prone to repeated episodes.
Surgery can help an acute disc episode but other discs can still rupture at a later date.
One thing I've noticed is that when I'm very strict with crate rest it seems to help with having fewer episodes.
Also, I went over my house with a fine tooth comb and tried to IVDD proof any potential hazards.
Keeping Sam at a healthy weight and regular walks (when not on crate rest) is good.
IVDD is a lifelong condition unfortunately.
God bless.
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PaulaM
Moderator. ![*](//storage.proboards.com/forum/images/stars/star_magenta.png) ![*](//storage.proboards.com/forum/images/stars/star_magenta.png)
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Feb 4, 2018 8:36:56 GMT -7
Diana, you ARE reporting pain (humped back, nose to the floor)! Call your vet and strongly advocate for adjusting Tramadol. Many vets do not appreciate that tramadol in dogs is quite different than for people IF it is known that the same disc is always causing repeated disc episode, then it may be a consideration to discuss with a neuro (ACVIM) or a an ortho (ACVS) to see if a surgery could help. If each time it is a different disc, one of the other 26 discs then the dog can likely recover with the least invasive method vs. an invasive surgery (invasive procedures always have an element of potential risk). Xrays would not prove which disc. MRIs can definitively diagnose which disc. A dog's main defense against further disc damage is dependent upon control over the core trunk muscles – this defense is eliminated during anesthesia for x-rays and for MRIs. Vertebrae illustration The neck C1-7, Chest T1-13, the low back L1-7 ![http://www.dodgerslist.com/literature/vertebraeillustration.jpg](http://www.dodgerslist.com/literature/vertebraeillustration.jpg)
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Post by Diana & Sam on Jan 1, 2019 11:05:16 GMT -7
Happy New Year! I would like to apologize for not posting Sam’s status. I have been dealing with my own health issues. Sam is doingwonderful, no pain, walking, only thing that did not come back is his tail, which he can not wag. Thank you to all of you for your support, without it, Sam would not be where he is today. Graduated Mar 2018![](http://www.dodgerslist.com/forumads/Graduate.jpg)
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PaulaM
Moderator. ![*](//storage.proboards.com/forum/images/stars/star_magenta.png) ![*](//storage.proboards.com/forum/images/stars/star_magenta.png)
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Jan 1, 2019 11:20:26 GMT -7
Diana, sorry to hear you have some heath challenges. But very sweet update on how well Sam is doing almost a year after his Jan 2018 disc episode!
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