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Post by Jeremy & Browney on Nov 13, 2017 18:14:18 GMT -7
Do you think the 200mg per day of the Gabapentin is enough? I have not given him that yet. I was going to give it to him in an hour.
[Moderator's note: please do not modify 17 lbs. Rimadyl as of 11/10: 12.5 mg 2x/day for 7 days, then 11/17 test for pain stop Tramadol 25 mg 3x/day Methocarbamol 125mg 3x/day Gabapentin 100mgs 2x/day famotidine 5mgs 1x/day due to heart meds Vetmedin 2.5mg in am/1.25mg in pm Furosemide 10mg 2x/day Enalapril 2.5mg 2x/day]
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PaulaM
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Post by PaulaM on Nov 13, 2017 18:36:05 GMT -7
Jeremy, if you are seeing pain with the new adjustments, the the meds would naturally still not right. Expect within the hour of the new med list all pain is fully in control. And that pain will not surface when having to move for potty or nearing the next dose. The usual is to use pain meds at an aggressive level because a disc episode is so very painful. If you see the pain is surfacing do you best job of advocating for a three x/day dose. Methocarbamol and these pain meds have a short half life Tramadol 50 mgs 3x/day gabapenting 3x/day Are you using a med chart where you can keep cause and effect notes, etc.? D/l and print from here: www.dodgerslist.com/literature/crateRRP/medchart.pdf
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Post by Jeremy & Browney on Nov 14, 2017 6:36:20 GMT -7
I made a spread sheet to track when we give him meds, but had not added any observational stuff. Thank you.
Browney seems to be feeling better this morning. He is not tight like he was, and did not yelp when I picked him up this morning. He is having trouble going potty on the pads though. He wet the bed again last night right after we put him in the cage in our bedroom. Then this morning, I took him to his potty pads and he didn't go, but after I put him in his cage, within 15 minutes, he went in there. It sucks because the poor guy is so sad when he does that. He just tries to clean it up.
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Marjorie
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Post by Marjorie on Nov 14, 2017 7:00:06 GMT -7
I'm very glad and relieved to hear that Browney's pain is now under control, Jeremy. Good news. Have you tried a sniff and pee test yet? Carry him outside to a spot where he peed before, let him sniff and see if he can release urine on his own. Or use a pad with pee on it from Brownie or another dog so he can sniff and see if he can release urine. The purpose of the sniff and pee test is to see whether there is a brain connection to the bladder. If he can't pass a sniff and pee test, he may have lost bladder control. Finding wet bedding usually means loss of bladder control. Did you see him deliberately urinate in his crate or did it just flow out of him? We were hoping that his pain was causing him not to want to move but his pain is now under control. If Brownie has lost bladder control, he will need to have his bladder expressed. Urine lying too long in the bladder can lead to a urinary tract infection. Also when the bladder overflows, it stretches out bladder tone. You'll need a hands-on-your-hands demonstration on how to express the bladder. Here's our page on expressing for your review prior to your demonstration: www.dodgerslist.com/literature/Expressing.htmPlease let us know if Brownie can pass a sniff and pee test.
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Post by Jeremy & Browney on Nov 14, 2017 11:39:34 GMT -7
He is not peeing when he sniffs the potty pad, but it isn't his urine on it either, it is the puppies.
I suspect it is the pain meds as he has acted this way before when on pain meds. I don't think it's any issue of him holding it in as he is going to the bathroom about the same amount is normal at this point, just not where we want him to.
Also you say you feel he may have lost control of his bladder, yet Paula told me that if he has not lost control of his rear legs yet that was not possible. This is a little confusing. Am I misunderstanding?
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PaulaM
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Post by PaulaM on Nov 14, 2017 12:44:15 GMT -7
Jeremey, if Browney still has the same neuro function status, it is not likely has has lost bladder control. Let us know his neuro status as of today if it has increased down the list to #5 or #6, etc.
As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross 3. Nails/toes scuffing floor 4. LEFT backPaw knuckles, RIGHT back leg normal function 5. Weak/little leg movement, can't move up into a stand 6. Legs do not work at all (paralysis, dog is down) 7. Bladder control is lost 8. Tail wagging with joy is lost 9. Deep pain sensation, the last neuro function
For the sniff and pee test could you take him outdoors to a grassy spot where he has peed before or another dog? Most dogs would abhor releasing body waste where they sleep unless they are not let out in time and have no other choice. Why is Browney doing releasing urine where he sleeps. Is he doing the same with poop or does he hold it til outside the crate on a pee pad or outdoors in the grass?
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Post by Jeremy & Browney on Nov 14, 2017 13:10:05 GMT -7
He is doing the same with poop or pee. So far it has happened after we give him the Tramadol. I will try him outside later. He has definitely not progressed on the list. He is able to stand and walk on his own, hes just wobbly still. I have not taken him outside since this happened, just feels more safe indoors. LOL Here is the medicine schedule I made for him. The Famotidine I stagger a little before the others, so 6am is a little off. I try to go 6:00 and then the others at 6:30. I am VERY happy to say he just peed outside. I took him to a spot he frequents and told him to go potty. He sniffed around for a second and immediately went pee.
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Marjorie
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Post by Marjorie on Nov 14, 2017 13:31:43 GMT -7
Wonderful news that Browney passed the sniff and pee test, Jeremy! So glad to hear it. Usually a dog won't pee or poop where they sleep and we don't see Tramadol causing this type of side effect so it was a bit puzzling. When my Jeremy had his first disc episode, he seemed to lose bladder control before he became paralyzed. He was having urine accidents in the house but was still walking. I took him to the ER vet because he never peed in the house before and I knew something was wrong. It may have been due to pain or fear but it didn't seem as though he could control it. He lost use of his legs the next day. He regained use of his legs in time and walked again but has never regained bladder control. Therefore my concern about Browney. Glad my fears were unwarranted.
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Marjorie
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Post by Marjorie on Nov 14, 2017 13:33:54 GMT -7
The Famotidine should be given 30 minutes before the Rimadyl and then every 12 hours thereafter for as long as Browney is on Rimadyl. 5 mg 2x/day.
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Post by Jeremy & Browney on Nov 15, 2017 6:23:17 GMT -7
So yesterday afternoon (11/14 around 5pm) he yelped when I tried to pick him up and did not want to let me. He takes 25mg Tramadol at 6am, and again at 2pm. His Gabapentin he got at 6am and would get again at 6pm, so he had not had that dose yet.
This morning (11/15 5am) when I went to get him from the cage in the bedroom to bring him out for potty he did not want me to pick him up and yelped a little when I did. He had Gabapentin last at 6pm the previous night, and Tramadol last at 10pm the previous night.
I think he needs something increased, but I am not sure what to ask for? I know the Gabapentin should be 3 times daily according to the info here, but does he need the same total dosage, just spread over 3 (200/3 = 66.6mg per dose 3x), or does he need the same single dosage, but just add another (100 pr dose 3x)?
Is Gabapentin the correct one to adjust, or should it be more Tramadol?
I realize this is something the vet should prescribe and don't plan to make these changes myself, just want to be more educated when I call.
------------ The vet did not want me to give him more than 5mg of Famotidine, once per day. She was concerned that it would conflict with one of his heart meds. I asked about Sucralfate but she did not want to prescribe that for him.
The vets office just called to check on Browney. I asked about the Rimadyl tapering (1/2 dose for day 8-14) and they said it wasn't for a taper like you would a steroid, but rather they try to not use more than necessary of that drug as it is bad for the dogs liver. So they prescribe the stronger dose for a short period of time first. This was a vet tech, not the vet I have been dealing with.
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PaulaM
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Posts: 19,792
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Post by PaulaM on Nov 15, 2017 9:17:34 GMT -7
Jeremy, glad you were able to rule out loss of bladder control for the cause of peeing in bed. So with your report this am, it appears Browney's peeing on his mattress may have been pain and reluctant to move??
Each of the pain meds he is on all have a short half life. That is why typically they are prescribed for every 8 hours. Because of his heart issue, you will have to discuss with the vet if possbile to move to a more aggressive pain med approach since clearly the meds are wearing off too soon at every 12 hours. --- Methocarbamol is currently Rx'd for what we observe vets using with a disc episode. --- Gabapentin every 8 hours at the appropriate dose in mgs. May well be say 50 mgs 3x/day would do, just have to see. Is it in a capsule? Then you would be able to open it, dump power in crease of paper sheet. Use razor blade to divide into two equal piles of powder. Make a well in a mashed banana ball. Scoop powder into well. Close up ball. Wash your hands. Gabapentin is VERY bitter. Wrap banana ball with yummy piece of deli meat. If Brownie gets wind of any bitter gabapentin dust he will be forever suspicious. Gapabentin can be compounded to a liquid. More expensive and be extra vigilant that no XYLITOL sweetener has been used.. it is toxic to dogs. Compounding can take days to get from a vet compounding pharmacy. Speciffy no XYILTOL in big warning on Rx if compounded by human local pharmacy as XYLITOL is often used for people preparations. --- It is known that tramadol is often dosed too lightly to be effective for dogs. Again here is the information below, you will have to find out if max dose of 50 mgs every 8 hours is ok for Browney.
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Post by Jeremy & Browney on Nov 15, 2017 10:13:16 GMT -7
I have a call in to the vet and waiting for them to call back to speak about the medications. I know the Tramadol she was hesitant to go much more because of his heart problem.
Ok, starting today he will get an increase in ▲gabapentin to 100mg 3x daily, and▲ tramadol 37.5mg 3x daily. They aren't comfortable with more than 37.5mg on the tramadol due to his heart.
[Moderator's note: please do not modify 17 lbs. Rimadyl as of 11/10: 12.5 mg 2x/day for 7 days, then 11/17 test for pain stop Tramadol ▲37.5 mg 3x/day max due to heart Methocarbamol 125mg 3x/day Gabapentin 100mgs ▲3x/day famotidine 5mgs 1x/day due to heart meds Vetmedin 2.5mg in am/1.25mg in pm Furosemide 10mg 2x/day Enalapril 2.5mg 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 Nov 15, 2017 11:15:02 GMT -7
Jeremy, keep us posted. Sure do hope this adjustment to the med list will give him full comfort round the clock.
You will want to check on the reduction of Rimadyl to happen on Nov 17. Clearly is it not time to reduce Rimadyl with so much painful swelling still existing.
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Post by Jeremy & Browney on Nov 15, 2017 11:27:37 GMT -7
My plan was to call them on 11/17 with info and to get further instruction. The vet did say we could increase that as well if needed, but they wanted to try increasing the other 2 first.
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PaulaM
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Post by PaulaM on Nov 15, 2017 12:48:15 GMT -7
Jeremy, it would be good to refresh yourself on how Rimadyl is used with a disc episode so you can best contribute and discuss things with the vet. The full article worth reading is here: www.dodgerslist.com/literature/healingsweling.htm Some points to note: --- Rimadyl is used only until there is no more painful swelling. A guess is taken, sometimes a 5- or 7-day course of Rimadyl. Then a stop of Rimadyl and all pain meds so you can give an accurate report to the vet should any pain resurface. Why NSAIDs like Rimadyl are serious meds which can carry serious adverse side effects: www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm196295.htm --- Since just two days away from the end of a 7-day course, Browney is still in pain, VERY unlikely that all pain will have been resolved in two days to try a test for pain stop of Rimadyl. Also Nov 17 will have the test falling near the weekend when the vet is not open. Does that make sense to you? It may take several courses all adding up to 30 days before the pain is gone. No one wants to be using Rimadyl one bit past the the benefit of all painful swelling gone. That is the reason to try a course, then test for pain. -- Pain= another course of anti-inflammatory + all pain meds+ Pepicd AC back on board. No Pain= no need of any IVDD meds...just finish out the 8 weeks of crate rest for the disc to heal.
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Post by Jeremy & Browney on Nov 15, 2017 12:56:02 GMT -7
Ok, so I'm a little confused. I am assuming I don't want to stop the meds in 2 days as we feel the pain won't be gone. If that is the case, what are you suggesting? I totally understand no meds over he weekend would be bad if he still has pain.
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Post by Romy & Frankie on Nov 15, 2017 14:18:08 GMT -7
When the dog is still in pain we know that the spinal cord swelling is still there and an anti-inflammatory is still needed. It can take up to 30 days on an anti-inflammatory before the swelling is gone. If Browney is still in pain today, we are concerned that he may still be in pain on the 17 which is only two days away. If he is still showing pain it is not a good time to stop the anti-inflammatory. The 17 is a Friday and we want to make sure that you are able to get in touch with to your vet prior to the weekend when a lot of vets are hard to reach and will have enough meds to get through the weekend,
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Post by Jeremy & Browney on Nov 16, 2017 5:18:02 GMT -7
Oh, I have enough of all of the meds to go for probably at least two weeks from now. They gave me plenty, and it is not hard for me to get more when needed. I did not plan to stop the medicine on the 17th just to call them and speak with them to check in and see what their recommendations were.
So yesterday afternoon around 4pm (11/15) Browney yelped when I went to tried to take him out to go potty. He had his tramadol and gabapentin at 2pm, so he should have been not feeling pain. This time though, I noticed he yelped before I actually touched him. Like the thought of it scared him. My wife came home and about an hour later, 5pm or so, she took him out and he did not yelp or cry at all. I will observe more today to see if it is me or him.
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Marjorie
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Post by Marjorie on Nov 16, 2017 5:42:19 GMT -7
If Browney yelped before you even touched him, then he may have been experiencing anticipatory pain. A dog will learn that moving hurt in the past so they're afraid it will hurt again if they move. Those fears should lesson as he continues without pain. See if you see any other signs of pain that would confirm that there is actually pain, such as trembling or tight tense belly. Please continue to let us know what you observe today.
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PaulaM
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Post by PaulaM on Nov 16, 2017 8:16:43 GMT -7
Jeremy, on Nov 17th Rimadyl is scheduled to go to a lessor level of half a dose that may no longer be as effective as it should be in resolving painful swelling. So in one day now, it may not be likely that all swelling is gone, therefore not time to reduce Rimadyl to a less effective dose. Something to discuss with the vet as to whether to reduce Rimadyl or continue a few more days at 12.5mgs 2x/day. Then do an actual test for pain after the weekend to see if he can get off of Rimadyl all together..
To know the health of organs such as the liver to be using Rimadyl, vets take a blood panel. When is the last time Browney has had a blood test?
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Post by Jeremy & Browney on Nov 16, 2017 11:35:15 GMT -7
I have no intent to change anything with any medication without previously talking to the vet. I do not intend to reduce his Rimadyl unless they say it is absolutely necessary. As for his blood they checked it less than a month ago when I needed to refill his prescriptions for his heart They told us everything looked fine on the blood test, though we did not get into specifics. I just took him outside to potty. He did not want me to pick him up and shyed away in the cage. I pet him and talked to him a little bit, and then was able to pick him up and take him outside and back in with no cries. Also, he lifted his left leg to pee. First time he has done that since this all started. Also, judging by the way he is acting today I think he is feeling better. He definitely was wanting out of the cage today. **I had to edit this as it said *with to cries and should have said *with no cries.** Here is a picture of his little sister sticking by his side. Rosey loves Browney.
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Post by Romy & Frankie on Nov 16, 2017 15:53:14 GMT -7
Really cute picture!
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Post by Jeremy & Browney on Nov 17, 2017 14:07:58 GMT -7
I called the vet's office this morning and left a message for the vet letting her know that I intended to continue his medicine through the weekend. I told them that I plan to cut off the meds for his back on Monday to see if he was still having pain. I let them know if there was any issue with this to please have the vet call me otherwise I would check in Monday. That was about 5 hours ago and I have not heard back so I think all is well.
[Moderator's note: please do not modify 17 lbs. Rimadyl as of 11/10: 12.5 mg 2x/day for ▲10 days, then 11/20 test for pain stop Tramadol 37.5 mg 3x/day max due to heart Methocarbamol 125mg 3x/day Gabapentin 100mgs 3x/day famotidine 5mgs 1x/day due to heart meds Vetmedin 2.5mg in am/1.25mg in pm Furosemide 10mg 2x/day Enalapril 2.5mg 2x/day]
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Post by Romy & Frankie on Nov 17, 2017 14:14:35 GMT -7
Sounds like a good plan to continue the meds for a few more days if the vet has no problem with it.
Browney shows no signs of pain now?
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Post by Jeremy & Browney on Nov 17, 2017 15:49:21 GMT -7
Sounds like a good plan to continue the meds for a few more days if the vet has no problem with it. Browney shows no signs of pain now? Not that I can tell. He still doesn't want me to pick him up, but he is totally fine with my wife doing it, so we are trying to just have her do all the moving. ROSEY, the puppy:As if one dog with issues isn't fun enough, the puppy got into some 40mg famotidine pills today. I think she may have ate 4 or 5 of them. Now we are monitoring her super closely as well.
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Post by Romy & Frankie on Nov 17, 2017 16:06:52 GMT -7
Please call poison control about this right away. Don't take a chance. The following is from the link below: Overdose of Famotidine is rare but symptoms of an overdose may include: Vomiting Restlessness Redness of the mouth and ears Rapid heart rate Collapse If you suspect or know you pet has had an overdose, it could be fatal so please contact your veterinarian, an emergency vet clinic, or the Pet Poison Helpline at (855) 213-6680 immediately. www.petmd.com/pet-medication/famotidine
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Post by Jeremy & Browney on Nov 17, 2017 16:49:48 GMT -7
ROSEY, the puppy: I am monitoring her very closely. She is not showing any signs of issues. She has no vomiting and her heart rate seems fine. She is playing right now and ate some boiled chicken about 20 minutes ago.
**Update for Rosey... I don't want to change the topic of this thread. She is doing fine. She has ate more food, had a normal poop, and is now tearing up a toy as usual **
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Marjorie
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Post by Marjorie on Nov 18, 2017 5:35:40 GMT -7
I'm glad Rosey had no problems due to her scary adventure, Jeremy. Amazing what dogs will eat. They sure can keep us on our toes!
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Post by Jeremy & Browney on Nov 18, 2017 7:06:20 GMT -7
This mornings observations for Browney... When I went to bring him out from the bedroom he didn't want me to pick him up, but he let me and did not yelp at all. This was at 5am, and he takes his pain meds at 6am, so he was at the end of his last dose. He was also rubbing his nose around on the blanket. He usually does that right before he rolls around on his back in bed, so I stopped him. He is very quick to move today in his cage and seems much better in general to me.
With that said, he does continue to have accidents in his bed. Thanks to the fleece blanket suggestion, it is dealt with quickly, but still no fun. I'm hoping once he's off his pain meds this will lessen. He has always been a little stubborn about going potty on command.
ROSEY, the puppy: Yeah, she is fine. Amazing the places she can get into. Rosey is like a little acrobat.
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Marjorie
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Post by Marjorie on Nov 18, 2017 7:29:15 GMT -7
Is Browney still urinating when you take him outside on potty breaks? Maybe he needs to go out more often. Is he drinking more water than usual?
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