Renette's Spikkie July 28 conservative HEART- South Africa

Renette, welcome to Dodgerslist Forum.

His pain meds are not YET right! What country are you in? I have to look up your meds to see what they are.

I need to know for each med you named... how many mgs is each dose,  how often do you give: every 8 hours, every 12 hours, etc.?

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Thank you foryou message. We are in South Africa. Just to confirm.,do you think there is hope for my Spikkels. He is 15 years old has 3legs and a heart condition. He has been parralized for two weeks just suddenly. He has lots op pain. He can however still control his bladder. He vomit allot, dont know if its from pain.He is on prednisolons tablets hi stopped the pax because i felt it made him worse as he was disorientated. He was on one pax 5 two times a day. It was given a week. I need be I will try it again. Tramadol has been given 3 x 50mg pils in 10mlwater and give 1ml two times a day. I uped that to 3times a day. Already been to two other vets, all had the same opinion. There is no NSiads because were scared of an ulcer of stomach

Spikkie have stomach pain dont know why that why we have buscopan. Yes he is strict cagerest. Loiks like the back disc. he is expression bladder self

It looks from exrays like 4calsified discs. We didnt do an mri as we cant afford.

Thank you. Is ulsanic enough to cover his stomach alone? What would you suggest I ask my vet for to prescribe as I realky dont think they now of this other options please. I mix the 3pills with water myself.

spikkie weight 8kg/ 17.64 lbs

.my email is currently not working I am trying to fix Problem thats why i am not registered.

They gave spikkels trameul injections 5jule in his back.    the nest day [7/6] he was paralized.

The  6July het started on 5 prednisolone pils for 5 days  [5mgs once a day]. Two days of five days again high dose. Only last two days on one pred two times daily.

Thank you I will get another stomach liner. Should I then give him one tramadol 50mg every 8hours.

Prednisolone 5x 5mg once a day for 5days starting 6 july tot 10July.

Two

11and 12July 1x5mg twice daily
13to 18July 5x5mg once daily.
19and20july 1x5mg twice daily.
19to 22july 5x 5mg once daily.
Today onwards sopose to give 1x5mg once daily.[ dog is in pain!!!]

Is there anything else I must give exept the line, prednisolone and tramadol please

The part of prednisolone that is important is the days before it is lowered to a taper dose. Taper doses do not work on the painful swelling.

Please look at my interpretation of what you wrote ONLY for what is at the anti-inflammatory level (no taper day info is needed.) 

Is this correct?
Prednisolone as of Jly 6: taper dose! 5mgs 1x/day for 5 days
                   as of July 11: 5mgs ▲2x/day for 2 days then taper to test for pain
                   as of July 19: 5mgs  2x/xday for 2 days, then July 22 taper to test for pain

IF above is correct your dog never got the anti-inflammatory level on July 6.

On July 11 and July 19  he got the anti-inflammatory level but only for a total of 4 short days! Your vet is not showing confidence in using the anti-inflammatory level for a long enough time--- spitters and sputters of 2-day courses!  No wonder he is in pain,  He basically has only had Pred for 4 days and insufficient pain meds.   All the rest of the days were too low a dose...below the anti-inflammatory level.  

See if you can be successful in strongly advocating with your vet to get pred on the higher end of the anti-inflammatory level dose along with double GI tract protection.  AND of course getting the pain meds correct for the duration it takes pred to completely resolve painful swelling. 

If your vet isn't comfortable or knowledgeable about treating IVDD and will not get the proper meds on board (getting Spikkie back on the anti-inflammatory dosage of Prednisolone 5 mg 2x/day for a longer period of time, getting the proper pain meds on board to get Spikkie's pain completely under control and getting proper stomach protection), then you'll need to find a new vet. It's very disturbing to hear of a dog that a vet has allowed to be in pain for two weeks when there are so many options. They are NOT doing all that they can!

Please keep us updated and let us know what the vet says and/or how you make out finding a new vet.

Healing prayers for Spikkie.

Renette, what "it is time" for is to fire your vet and hire a vet who is more IVDD knowledgeable! What is the harm if your vet is willing to kill your dog to prescribe another course of pred and provide pain meds to relieve pain?

You will  need a vet to be supervising the use of Prednisone.  This is one med you do not want to mess with-- a vet is needed for spikkie.

When you find a vet who knows IVDD you can advocate for getting the pain meds on board you have in hand.

CAVEAT: It is important to do your own reading about meds so you can participate in discussions. The reason for you to not self prescribe is your vet has responsibility for the health of your dog in meds he prescribes based on his exam, the health history of your dog, how meds interact, not things we or you might know as we are not veterinarians. Vets should be open to treatment options because vet medicine is not a black and white science. If you are not satisfied with how your vet handles this disc episode, then there is a need to hire a different vet who is comfortable in treating a disc episode. A specialist (Neuro ACVIM or Ortho ACVS) consult may be in order as they use meds on a daily basis to control pain.

Advocate for and expect with your new vet proper pain relief (in light of his heart issue your new vet may see a need for different dose levels than for a healthy patient)
1) Methocarbamol (Roboxin)  Initially, methocarbamol is dosed at 7 to 20 mg per pound (15mg/kg to 44 mg/kg) up to three times daily. The dose of methocarbamol should not exceed 150 mg per pound (300 mg/kg) per day.
www.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspx

2) Gabapentin Dose recommended (empiric) for gabapentin: 10–20 mg/kg every 8 hours. "Outpatient oral analgesics in dogs and cats beyond nonsteroidal drugs: An evidence-based approach." KuKanich B. Vet Clin North Am Small Anim Pract 43(5):1109-1125, 2013.

Getting a consultation from a specialist is not just for the purposes of a surgery. When your local general vets are not comfortable in using medications, then a specialist who does this daily, is a benefit to get the meds right.

I still have more preds since we spoked I uped the dossage to one 5mg two times a day

Not all specialists are the same, I'm sorry you got one was not helpful with your 15 years old YOUNG dog! Can you seek out a different specialist OR get the one you saw to understand. Make it clear, you want his support in keeping pain at bay while pred is at work with swelling with this current specific disc. You will not hear of killing your dog over a disc episode, PERIOD!  Isn't a vet's job to help a dog and not offer to kill?

Without an MRI, there is no telling which disc, certainly quite liiely it is NOT all of his discs causing the problem now. Not all calcified discs bulge or herniate. A calcified disc doesn't always mean that is the disc having a current problem.   So without an MRI's ability to specifiy which disc, you are treating all discs the same with rest. Pred and pain meds are to give comfort while the disc heals.

It would be helpful to give the credentials of the vet you meet with. A general DVM vet or a specialist ortho or a neuro vet. It helps us to understand things better.

Also when mentioning meds, it is extremly helpful and saves back and forth time of asking you, to always provide mgs and how often actuallly given.

Since pain you have reported pain signs with the meds you are now given, Spikkie needs still needs his meds adjusted.

--Pain relief from nerve pain every 8 hours.

--While Pax (diazepam) can help with muscle spasm pain for some dogs for others it will not help. "Diazepam is an excellent muscle relaxant, but in dogs reaches inconsistent and generally poor blood levels after oral administration. More frequently used are drugs such as methocarbamol." James M. Fingeroth, DVM, DACVS. "NSAID/steroid Decision-Making, Management, and Referring the "Disc" Case." Surgery. January 2006  dcavm.org/06jan.html  Last accessed 2014