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Post by Lex & Louie on Sept 24, 2018 18:22:33 GMT -7
Louie is a two year old mini Dachshund and was diagnosed yesterday with early stage IVDD. He can go potty (pee and poo), walk around, eat and drink. He does seem hunched over intermittently or tucks his tail with some shaking he has not made any noises in pain unless we gently pet his back. we were told to do strict crate rest for 3-4 weeks, only time out is for potty / eating. Also on Gabapentin, meta cam (anti inflammatory) and an anti anxiety med. he seems to do well in the crate, seems to want to go potty and eat, he’s only been medicated for 24 hours but is the discomfort / pain yelp normal with slight touch? Is it normal for him to be uncomfortable even with the meds ? I feel like I’m being dramatic but I’m just not sure what’s normal. All I know is they said him walking and going potty by himself is a great sign for recovery.
Just to add he is roughly 10 lbs, he has been slightly pigeon toed in his hind legs since birth but has always gotten around normally and pain free.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 24, 2018 19:23:22 GMT -7
Lex, Louis IS IN PAIN because his pain meds are not yet right... He is under medicated for a disc episode. that needs addressing first thing in the AM with vet. Would you fill us in on the details of his med list Metacam for how many days is he to take? Gabapentin ? mgs ?x/day name of anti anxiety pill? ? mgs ?x/day Expect med adjustments of ---Pain meds are usually three and given promptly every 8 hrs. --- Tramadol as the general analgesic --- Gabapentin for nerve pain --- methocarbamol for muscle contraction pain. -- Pepcid AC (famotidine) from the grocery store every 12 hrs till off of Metacam. WHY STOMACH PROTECTION Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health issues” answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). The usual dose during a disc episode is 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 Smallest size tablet Pepcid AC comes in is 10mgs  Let us know you are on the same page about crate rest: The centerpiece of "DISC disease" treatment is the healing of the disc via limited movement of the back via a recovery suite. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong disc scar tissue to form. --Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm --PLUS further guidance on conservative treatment on our "All Things IVDD page: www.dodgerslist.com/literature/healingpage.htm www.dodgerslist.com/healingindex.htmSTRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no meandering at potty times. Carry your dog to and from the recovery suite to the potty place and then allow a very, 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!  |
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Post by Lex & Louie on Sept 25, 2018 3:47:14 GMT -7
50 mg Gabapentin. Give 0.75 ml by mouth 8-12 hours It is 50 mg/ml dosage of Gabapentin
Metacam 1.5 mg .3 ml by mouth every 24 hours
Trazadone 50 mg Give 1/2 to 1 tab by mouth 8-12 hours
I called the vet this am and left a message to call me regarding his meds.
Will also be getting Pepcid ac today to give him to help his belly.
[Moderator's note: please do not modify
10lbs
Metacam as of 9/23: 1.5mgs (0.3mL) 1x/day for 7 days then 9/30 stop to test for pain/neuro loss
gabapentin 50mgs/mL: ▲50mgs (1-2mL) 3x/day
Trazodone 25mgs every 8-12 hrs.
Pepcid AC 2.5 1x/day ]
They didn’t specify for 8 or 12 hours. I have been sticking for Gabapentin between 8-9 hours due to my work schedule.
He is on Gabapentin and metacam for 1 week. Trazadone for 30 days.
Pepcid ac I was going to consult with my vet about how often when they return my call to see what is best for his size.
Mu vet said the emergency vet dose of ▲Gabapentin was too low so she upped it to 1ml up to 2 ml by syringe if needed.
That I could continue Gabapentin an extra week if needed.
And to do 1/2 of a 5 mg Pepcid ac tablet daily.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 26, 2018 9:23:12 GMT -7
Lex are you finding the increase of gabapentin to a 50mgs (1mL) dose 3x/day is keeping pain fully at bay now? The scheduled date for the test for pain stop of Metacam is to happen on Sunday 9/30 when the vet is not open. With the stop Metacam, it is always good to have worked out in advance a "PLAN B" should pain re-surface at night or on the weekend when your vet is not open. Could be an emergency RX script you could fill at local 24 hr pharmacy or some extra pills at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free with a few extra Metacam pills on hand in case til your vet opens Monday morn! RULE OF THUMB
Pain= another course of Metacam + all pain meds, stomach protectors back on board. No Pain= no need of any meds...just finish out the 8 weeks of crate rest for the disc to heal. On the stop of Metacam it is usual to either back off the pain meds or just full stop them. This provide you with a clear window without pain masking meds on board to see if any hint of pain resurfaces. Pain resurfacing tells you and the vet not all the swelling had been resovled and the need for another Metacam course. It can take anywhere from 7 to 30 days for Metacam to work. Of course, if Louie still is showing any signs of pain before Sunday, then there is no need to do the test-for-pain stop of Metacam on Sunday. Instead your vet needs to know pain meds need further adjustment. --- adding methocarbamol for muscle spasm pain 3x/day --- adding tramadol as the general analgesic 3x/day Let us know what your vet wants on the stop of Metacam this Sunday... backing off pain meds or full stop of them. |
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Post by Lex & Louie on Sept 26, 2018 14:44:00 GMT -7
So Louie went in today to the ER at 3 am for vomiting due to metacam upsetting his gi tract they gave him a shot for anti nausea. As the day progressed he developed a cough. Took him to my vet and. We did an X-ray and he was diagnosed with aspiration pneumonia. They gave him an antibiotic shot opposed to oral meds which could upset his gi more. The shot is less upsetting. The vet did a full exam on him and felt his spine. He is not in pain with the 1ml of Gabapentin and we are stopping the metacam for now. I do have some left if I need to restart. We will continue with .75 to .1ml of ▼Gabapentin for the rest of the week. I have a follow up appointment on October 13 for second X-rays to make sure pneumonia is gone and to see how he is doing with his back. Using trazadone as needed at this time.
[Moderator's note: please do not modify
10lbs
Metacam as of 9/23: 1.5mgs (0.3mL) 1x/day for 3 days STOPPED 9/26 3am due to GI tract damage
gabapentin 50mgs/mL: ▼37.5mgs-50mgs (0.75-1mL) 3x/day
Trazodone 25mgs every 8-12 hrs.
Pepcid AC 2.5 1x/day
name of nausea shot on 9/26?
name of antibiotic shot on 9/26?]
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Post by Romy & Frankie on Sept 26, 2018 14:56:25 GMT -7
I am very sorry to hear that Louie developed pneumonia and I hope that with the antibiotics he will be feeling better soon.
Louie has only been on an anti-inflammatory for three days which may not be enough time to reduce the swelling in the spinal cord that causes the pain and any neuro losses like trouble walking, etc. If you see any signs of pain, which would indicate that there is still swelling in the spinal cord, additional time on the Metacam should be considered. This time, you should consider having his stomach double protected against the excess acid caused by all anti-inflammatories. In addition to the Pepcid AC, speak to your vet about Sucralfate. Sucralfate works differently than Pepcid AC. Pepcid AC reduces stomach acid while Sucralfate serves as a sort of bandage for any damaged areas and helps to heal them.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 26, 2018 17:18:55 GMT -7
Lex, what are the names of the 9/26 nausea and the antibiotic shots It can take Metacam 4- 7 days to fully leave the body. It might be prudent to be using the more aggressive end of the famotidine range now: 5mgs every 12 hours. Famotidine may depend on the name of the shots given whether famotidine should be given or not. ER would be staffed tonight where a vet can look up Louie's file and you can get an answer. The usual dose during a disc episode is 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 |
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Post by Lex & Louie on Oct 1, 2018 6:12:25 GMT -7
Sorry I have been busy with work. Louie is only on pain meds as needed at this point. I did consult with the vet and do 3 extra days of anti inflammatory meds Thursday, Friday and sat only. Along with that we gave him Pepcid ac and anti nausea meds and he did fine.
[Moderator's note: please do not modify
10lbs
Metacam as of 9/23: 1.5mgs (0.3mL) 1x/day for 3 days STOPPED 9/26 3am due to GI tract damage
as of 9/27: 1.5mgs (0.3mL) 1x/day for 4 days
gabapentin 50mgs/mL: 37.5mgs-50mgs (0.75-1mL) 3x/day
Trazodone 25mgs every 8-12 hrs.
name of nausea shot on 9/26?
name of antibiotic shot on 9/26?]
He is feeling much better and doesn’t seem to be in any pain. We are going back to the vet on 10/13 for a follow up exam and X-rays to make sure his pneumonia is gone. he is no longer coughing or trying to throw up. I am unsure of the antibiotic shot the vet gave him for pneumonia I would have to look at my paper work when I get home. I was curious as to what is next? After crate rest should he do chiropractic therapy or acupuncture? Physical therapy?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Oct 1, 2018 7:41:44 GMT -7
Glad to hear you report that he doesn't seem to be in pain when on pain meds. Could you clarify a bit more. --what pain meds are you actually giving? what dose? how often? When you last wrote there was only one pain med (gabapentin). Did another get added? NEXT ---get proof that all painful inflammation is now gone with a stop or backing off of all pain masking pain meds. FYI: Trazadone is an anti-anxiety med not a pain med. At home you would be monitoring for any hint of pain surfacing to alert the vet if there is pain. Let us know when all pain meds will have stopped and what is revealed. RULE of THUMBpain = swelling = back up at anti-inflammatory dose, pain meds and Pepcid AC--- finish all 8 weeks of crate rest so that the disc can heal, then it will be safe to begin a gradual increase in physical activity. At the end of 8 weeks it the time to best observe his walking ability and decide if you want to pursue PT at a clinic or do some at home. We'll have more on that as graduation day approaches. Chiro involves movement to the back in thrusts. Without first having an expensive $1000+ MRI to know where there are problematic discs a vet would be doing chiro in the blind on your IVDD dog. Some dogs can have multiple disc episodes over the course of their life while other have just one. To have a better understanding of why no chiro, we asked board certified neuro (ACVIM) --- Dr. Isaacs to help the IVDD community by telling us more. Here is the link for you to read: www.dodgerslist.com/literature/chiropractic.htm |
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Post by Lex & Louie on Oct 1, 2018 11:14:37 GMT -7
He is on Gabapentin 50 mg 1 ml in 8-12 hour segments. Trazadone we give him 1/2 tablet every morning to keep him calm while I’m at work. Today was the first day we are not doing pain meds per the vet. He is walking fine and going potty. He only had one dose of Gabapentin yesterday and Saturday 1 ml and 1/2 trazadone yesterday as well. He is Eating / drinking. He is not on metacam the anti inflammatory meds anymore but we do have some left if needed. We also have extra Gabapentin if we need to use it if we see he is in pain.
[Moderator's note: please do not modify
10lbs
Metacam as of 9/23: 1.5mgs (0.3mL) 1x/day for 3 days STOPPED 9/26 3am due to GI tract damage
as of 9/27: 1.5mgs (0.3mL) 1x/day for 4 days STOPPED 10/1
gabapentin 50mgs/mL: 37.5mgs-50mgs (0.75-1mL) 3x/day STOPPED
Trazodone 25mgs every 8-12 hrs. STOPPED
name of nausea shot on 9/26?
name of antibiotic shot on 9/26?]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Oct 1, 2018 13:41:36 GMT -7
Lex, hoping to hear of a clear test for pain stop of Metacam and gabapentin shows you no pain, no more swelling. Keep us posted!
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Post by Lex & Louie on Oct 4, 2018 5:15:46 GMT -7
He is on no Gabapentin or metacam as of Sunday. He is doing well and does not appear to be in any kind of pain. In fact he seems quite himself and is not a fan of the kennel. We are giving him trazadone 1/2 tablet as needed for anxiety / anxiousness or if we have a guest over so he does not get too excited while crated. He seems to be comfortable. No shaking or crying. We have a follow up vet visit on October 13
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Oct 4, 2018 5:26:42 GMT -7
Great news that Louie has been able to be weaned off of the anti-inflammatory and pain meds. You now have proof that the swelling has resolved. All that is left to do now is to complete the 8 weeks of strict crate rest.
I hope all goes well at the vet visit on October 13 and no further signs of the pneumonia, Lex. It sounds as though Louie is doing very well at this point. Be sure to secure his crate in the car and pad it well with rolled up blankets/towels to prevent him from being jostled around too much during transport to the vet with as little movement as possible at the vet's office.
Keep up the good work caring for Louie!
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Post by Lex & Louie on Nov 7, 2018 12:38:51 GMT -7
Louie is doing well. He is almost done crate rest. The vet said we could do short 5-10 minute walks and short supervised time out if the crate with the leash on. So we are slowly doing those things. He seems very normal and happy. Does not show any signs of pain or discomfort after his incident. He is now on a joint supplement he takes daily that the vet recommended.
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Post by Romy & Frankie on Nov 7, 2018 14:05:57 GMT -7
I am so pleased to hear that Louie is doing so well. Louie is approaching, but not quite at, the end of crate rest so be very, very careful with your walks. The full 8 weeks of crate rest is what we have seen provide less chance of relapse. I am not sure if you have had a chance to see out tips on how to make your home back friendly: www.dodgerslist.com/literature/protectback.htm |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 7, 2018 18:31:32 GMT -7
We see dogs doing less than 8 weeks of conservative crate rest, often have a relapse to the early healing disc. We do also see that some few dogs whose owners prefer less crate rest do fine with fewer weeks of rest. There is no way to tell ahead of time which category the dog will be in. At Dodgerslist we are very cautious and follow the vets who do recommend 8 weeks of rest having seen too many dogs on the Forum re-injure a disc with less crate rest ending up with more pain and may need a $4000-8000 surgery. 8 weeks of rest is of course not scientific proof, just an observation over many years and many, many 1000's of dogs. The focus of the 8 weeks is getting the disc to form good secure scar tissue. Muscles may atrophy during crate rest, but when it is safe to do active PT at graduation day of Nov 18th, muscles soon bulk up.
Dodgerslist does err on the side of being conservative on crate rest time. Since 2002 and well over 10,000 dogs we observe dogs who complete the 8 weeks more often avoid a relapse during the conservative treatment period than dogs who have a shorter confinement period.
All of life is a weighing of the risks vs. benefits. Is 8 weeks to give the most assurance the disc has healed too much? Is 8 weeks in the total life span of a dog too much time to invest? I can say that I've not observed since being here in 2007 a dog harmed from 8 weeks of rest, but I have observed too many being harmed with less crate rest.
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