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Post by Diana & Rinzler on Mar 4, 2019 18:49:45 GMT -7
1. 60lbs
Meds started 01/02/2019 ** "as needed"
Gabapentin 100mg 2 x every 8-12 hours
Carprovet 100mg 1/2 tablet as needed (I've started giving this 1-2x daily, recently)
Tramadol 50mg 1-2 tablets as needed (I only give this if he's yelping- he will vocalize his pain)
Hemp Oil 100mg of active CBD Usually giving 1 full dropper as needed up to 2x/day
Fish Oil 1000mg 1 pill daily
NuPro Joint & Immunity Supplement Giving the recommended amount for his weight (sometimes a bit more)
[Moderator's Note. Please do not edit
60lbs
no crate rest prescribed!
Carprovet as of 1/2: not given often!! Rx is for: 50mgs 2x/day for how many days?, then a test stop
gabapentin 200mgs every 10 hrs due to wrk schedule
tramadol 50-100 mgs not given promptly on a schedule!
No GI tract stomach protector Pepcid AC on board!]
2. Pitbull mix, 6.5 years, neutered Rinzler Your name? Diana
3.Yes, IVDD diagnosis (I have the x-rays if that's helpful for anyone) but it's in his neck/cervical spine (C5, 6, C6-7 are the most severely affected) and some changes in T-10 to L-1 so they're suspicious. General Practice DVM.
4.Planning to start [STRICT REST] this tomorrow (aka tonight) - I received some conflicting information. The vet was SO knowledgable, but I was out of town and received a very descriptive voicemail. However, the office staff/techs have tried to be helpful, but unfortunately, aren't as informed so I've been receiving information that wasn't helpful it seems. I will be back at the vet for a different dog on Monday the 11th, so I will speak with her then as well.
5.Yes, specifically yelping when he goes to shake his head/turn his head. I started using more of the meds fully as in the past few days the Gabapentin doesn't seem to be helping anymore (originally he did GREAT with just this medicine)
6. Yes, he's functioning all cylinders other than yelping if he shakes his head, turns it, or pushes it into something. He's slowed down, but definitely active and hyper.
7. Yes, he seems slower (he squats like a lady dog) but doesn't seem to have any trouble.
8. Eating and drinking OK? Poops OK - normal color no dark or bright red blood? Yes.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 4, 2019 20:50:22 GMT -7
Diana, glad you have joined us. Glad to hear you will implement the single most important part of treatment tonight March 4. It is the crate rest, 100% STRICT crate rest 24/7 only out of the recovery suite for a very, very few footsteps at potty time that allows the disc to heal. First thing in the AM, phone your vet and report that Rinzler is in pain when moving his head. Anything that can be handled over the phone should be. The disc can't heal when there is too much movement. Transporting a big dog is not easy to keep the disc protected...vets who know IVDD understand this problem. So anytime out of the recovery suite is a dangerous time for the disc early formation of scar tissue. When the disc is damaged it in turn can do bad harm to the spinal cord nerves. Rinzler is quite a lucky boy that the disc did not rupture and cause severe severe nerve damage. You have an emergency to get his pain meds correct. There is no reason for him to be in pain. The pain meds all have a short half life and don't provide round the clock, dose to dose pain relief unless prescribed and given promptly every 8 hrs. - Carprovet (carprofen) How many mgs in one tablet? What you report is unclear and seems to be outside of the Manufacturer's recommended dose. Did your vet tell you to vary the mg dose 1 or 2x/day?
Rimadyl (carprofen) pkg insert: - gabapentin - How many mgs in one capsule? How many capsules do you even at one dosing time? Make sure you give it promptly on time every 8 hrs. - tramadol for a 60 pound dog 50mgs is like not giving anything! Please have a serious discussion on moving to the max aggressive dose in mgs promptly given every 8 hrs. -- Methcarbamol should be added to be given promptly every 8 hours. Muscle contraction pain is very typical with a neck disc. - - Buy Pepcid AC (famtodine) at the grocery store. See below on exactly how to phrase the question to your vet about using Pepcid AC. STOMACH PROTECTION is a must 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). Do read up on each med you dog is taking...it is a must to be informed at the Mar Vista Vet website:http://www.marvistavet.com/pharmacy-center.pml 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  As of today Mar 4, conservative treatment is basically back at square one. Crate rest for 8 weeks, all the anti-inflammatory days are basically negated. He'll need a blood test to verify organs are healthy to continue perhaps 7 and even up to 30 days on Carprovet. Please keep us posted on the adjustments to the meds. That Pepcid AC is on board. |
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Post by Pauliana on Mar 4, 2019 20:52:10 GMT -7
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 ability to form scar tissue. Conservative management is successful in 2/3 of dogs with a cervical disc episode, while 1/3 require surgery to physically remove the offending disc material. With neck episodes, neuro diminishment may include some weakness in the front limbs…the dog might slip while trying to walk. Idea to turn into a DIY Front leg harness for support while taking the fewest of footsteps at potty time. Make sure the medications are fully controlling pain from dose to dose with no break through in pain. Continued phone 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. Medications given for a disc episode are never given as needed.
Neck disc episodes are so painful and Rinzler needs to be pain free from dose to dose in order to heal. Pain slows down healing, so have no patience. The meds should be given on schedule promptly!!Classic signs of neck disc pain in addition to yelping and shivering/trembling may include: ◻︎ arching of the back to limit painful movement of the neck ◻︎ head held high or nose to the ground ◻︎ using eyes to look rather than turning head ◻︎ not eating due to painful chewing or in too much overall pain ◻︎ holds front or back leg flamingo style not wanting to bear weight (root signature pain) These are the typical pain medications used to treat IVDD to address each source of pain: 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 painful muscle spasms. Also prescribed every 8 hours. Gabapentin for nerve pain. Veterinarians are finding this medication works synergistically in combination with Tramadol. Amantadine. When the above three meds have been Rx'd at the aggressive dose in mgs and at every 8 hours, but pain is still not fully controlled, then advocate for the addition of amantadine - allows other analgesics to function more effectively. The Mar Vista vets explain the mysteries of amantadine marvistavet.com/amantadine.pml Both classes of anti-inflammatories require stomach protection. The steroid class is the most powerful of the two classes (Prednisone, Dexamethasone, etc.) The lessor class are the NSAIDs (Rimadyl, Metacam, Deramaxx, etc.) Anti-inflammatories should be accompanied by a stomach protector such as Pepcid AC (famotidine) to avoid serious gastrointestinal damage. For some dogs Pepcid AC is not enough and needs to be accompanied with yet another protector, Sucralfate, when there are signs of GI problems of diarrhea, vomit, bleeding ulcers, bloody stools. An anti-inflammatory, steroid or non-steroid NSAID, can take 7-30 days (exluding any steroid taper days) to resolve all pain. During a test-for-pain steroid taper is the time to watch for any returning signs or increased neuro diminishment. NSAIDs do not require a taper. Pain/neuro diminishment indicates another course of the steroid or the NSAID. After repeated attempts to go off any anti-inflammatory, if pain cannot be totally resolved, surgery becomes a consideration. NOTE: Danger to give a NSAID and steroid together or switch without a 4-7 day washout. These are additional things you can do at home to help with a cervical disc problem during the 8 weeks of 100% STRICT crate rest 24/7 only out of the recovery suite for a very, very few footsteps at potty time with conservative treatment: Raise food and water bowls to head height to avoid bending down to eat and drink. [photo how to] If you feed kibble, moisten each meal with equal parts water and kibble. Store in the fridge overnight to soften and rehydrate. Before serving, warm slightly in microwave, just to take the chill off. 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 disrupt the healing process of the disc, causing more pain and more time to heal the disc. Pain meds must be adjusted to give full round the clock 24/7 comfort from pain. Your dog may like a rolled up blanket or bolster where he can choose to rest the head on or lean against. Mary's tip: warm up light-in-weight-100%-synthetic fleece in the dryer to drape over shoulders/neck for coziness. Raise the crate up on a table so there is no need for your dog to to raise the head to look at you or watch the world from his recovery suite. During conservative treatment, anytime out of the recovery suite is a dangerous time for the healing disc. Movement of the back/neck can increase a disc tear and escape of disc material into the spinal cord. Healing thoughts for you and Rinzler! |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 4, 2019 20:55:44 GMT -7
CRATE REST 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. We carry our little dogs to and from the recovery suite to the potty place and then allow a very, very few limited footsteps. You will have to figure out how you can limit the number of footsteps he takes getting to the potty place to the bare minimum. 60lbs is too much for you to safely carry. Using a harness and a 6 foot leash is how you control speed and from darting off. You stand in one spot and limit his potty and sniffing. Alternate is a 6ft diameter fence as the visual and physical to let him know no sniff festing allowed.  Let us know more about your home/yard situation, we may have more ideas we can share. Will he pee on a pee pad adjacent to the crate? |
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Post by Diana & Rinzler on Mar 4, 2019 22:11:41 GMT -7
Thank you all SOOOOO MUCH! It's such a relief to have information to make some progress. It seems the tech that explained the medications didn't do very well. She explained what each did, but also advised me to tier them: Gabapentin-Carprovet-Tramadol and to increase the dose to the suggested max for each and/or add the next medication "up." OH BOY. - Gabapentin is a 100mg capsule and I give 2 (200mg) each time. This averages around 10 hours depending on our work schedules.
- Carprovet (carprofen) I haven't been giving him often because of the misinformation until now. I have 100mg tablets- it says to give a half tablet (50mg) every 12 hours. [=100mgs total daily]
- Tramadol- I AGREE! This is the medication I've gotten from doctors in the past for myself and it just seemed insanely low.
- Getting the Pepcid AC ASAP
Definitely calling the vet tomorrow AM to get his medications figured out and the Methcarbamol.
Also, thank you for advising no kong toy/treats. I was hoping to use frozen kongs as a sort of mental stimulation, but I will definitely NOT be doing that now.
On that note- do you think there is any way to keep up mental stimulation while on strict crate rest? He's a "run through the wall" kind of sport dog, and while he has no choice, I'd just like to make his strict crate rest not like a punishment.
Fingers crossed, I'm hoping I can have my BF take him out to potty every time. While I weightlift, I'm still short- he's 6'6" and can very carry him easily.
Also planning to skip getting another foster dog after my current dog gets adopted so that he won't get overly excited about a new dog in the home. Bummer, but glad I had all of this information to make this decision before it came up.
Moving him to a large crate vs. a medium crate sounds like a good idea from your suggestions, while it won't give him a ton more room, it will let him stretch out all of the way.
Thank you again for all of your help everyone!! I'm so glad someone referred me to you! |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Mar 5, 2019 5:40:42 GMT -7
Hi, Diana. Please keep in mind as you speak to the vet this morning that each of the pain meds - Tramadol, Methocarbamol and Gabapentin - have short half lives and work best when given 3x/day (every 8 hours). It's important to keep Rinzler's pain completely under control as pain does hinder healing. Meds need to be given consistently and never "as needed". Is there anyone who could stop by during the day to give the meds so Rinzler can rest in comfort and not have any pain arise? Boredom isn't a terrible thing during conservative care because hopefully a bored dog will just sleep since rest is what he needs. Place the crate so Rinzler will be in the middle of family activities, near your bed at night. Secure crate to a flat moving dolly (or put caster wheels on wire crate) to easily move the crate room to room. Good low cal snacks are carrots, apples, or frozen green beans, licking a frozen low sodium broth ice cube. Good thick low salt/no fat chicken broth is full of cartilage-building proteins and amino acids. Freeze it up into cubes for easy access as you need it. Fun and keeps the body hydrated: place cubes in a bowl for licking. Keep a happy voice and face around Rinzler so he's assured that there is nothing wrong and all is well. www.dodgerslist.com/literature/CrateRRP.htmGood thing that you have a BF that can lift and carry Rinzler. When lifting, support both the front and the rear and keep Rinzler's back horizontal to the ground.  If your BF isn't available for each potty time, here are some tips for large dogs. If he'll go on a pee pad inside, that might be helpful as you could just place the pee pad right outside of the crate door. Caster wheels can be purchased and put on wire crates so the crate can be wheeled outside. Do what it takes to limit the footsteps to potty. Keep the recovery suite by the exit door. Make a ramp over steps. If you do not have a deck off a sliding door, then consider this idea. Obtain an ex-pen to use at potty times where you would enlarge the very small recovery suite area just a bit. Lay down a pee pad WITH the addition of urine from another dog or from Rinzler on top. Always save a used piece of pee pad in a ziplock bag to use at potty time. Rinzler can learn it is ok with you to pee on the pee pad, be sure to use the command go potty and when he does give lavish praise. Please let us know what the vet says after speaking with them this morning. Please also confirm that Pepcid AC is now on board and the dosage being given. Healing prayers for Rinzler. |
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Post by Diana & Rinzler on Mar 5, 2019 19:32:55 GMT -7
Got the Pepcid AC! Yeehaw!
I called the vet today and wasn’t able to speak with my vet, but a different one that was there, as well as a vet tech before that as well. The vet confirmed that all meds should be used- I forgot to ask about moving to administering every 8hr, but plan to do that anyway. I have to go in for another vet appointment if I want the Methcarbamol... his original appointment was mid-December so I understand the timeline. However, I still find it irritating that they want me to drag him down there to see him when seeing him won’t confirm anything except that he’s drugged up.
With that said- do y’all think I can forgo the Methcarbamol with everything else that I have? They’ll refill all of my current prescriptions as is. AND I have an appointment with a different vet that does acupuncture for intervertebral specifically on the 19th (the earliest they had). That vet office is a general office too so I may just switch overall since they definitely understand IVDD.
Also, do y’all think the 19th is too soon for acupuncture?
Rin LOVES the large kennel and large round bolster bed and blanket we have in there for him. We’ve also got a water bowl that attaches to the kennel that has come in handy. He’s eating well and staying relaxed (he gets a little too excited when he sees the leash to potty, but I’m sure that will get old soon. So far, so good. He seems A LOT better, aka more comfortable, already.
ALSO, my bf never got him microchipped... I assume this is out of the question currently since it’s all up in his neck. Do you think I should forgo microchipping him completely because of this issue?
I don’t have anyone to come over during the day. I’m going to see if I can make it so I either get up earlier or just get up in the middle of the night to make it work with our varying schedule. I’m going to work on writing that out now.
Thanks again for all of your help!! I feel so much more confident with being able to handle this properly and make sure my baby will heal properly.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 5, 2019 20:31:01 GMT -7
Diana, as always we need to know from you what the dose in mgs and frequency of meds. Tell us about the Pepcid AC, please.
For how many days is the carprofen to be given before a stop as a test for remaining pain and or any neuro issues?
Is tramadol now promptly every 8 hrs at 100mgs dose?
Any vet at the same clinic who has access to Rinzler's files, can Rx for painful muscle contraction without endangering the early healing disc. Very, very often muscle pain comes with a neck disc and thus mehtocarbmol is used. Vets who know IVDD understand that especially with a big dog transport is often a BIG issue in keeping the neck and back with little movement and thus are willing to speak with you over the phone. Then you pick up meds at the clinic or the Rx is called into local pharmacy for you. Do your best job of advocating for methocarbamol is his pain is not being fully managed dose to right up to the next dose, fully round the click pain relief.
LASER or ACUPUNCTURE for severe neuro damage is best at home via a mobile vet. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment during conservative treatment.
Pain should be controlled by proper pain meds...so no reason for acupuncture. Rinzler has no neuro deficits so no need of acupuncture. What is your reason, what benefit for wanting acupuncture? If there is no mobile vet to come to your home, best to cancel appt.
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Post by Diana & Rinzler on Mar 8, 2019 10:47:48 GMT -7
Pepcid AC is 20mg every 12 hours currently.
Tramadol is 100mg every 8 hours.
[Moderator's Note. Please do not edit
60lbs
no crate rest prescribed!
Carprovet as of 1/2: 50mgs 2x/day for how many days?, then a test stop
gabapentin 200mgs every 10 hrs due to wrk schedule
tramadol ▲100 mgs ▲3x/day
✙Pepcid AC 20mgs 2x/day
The vet that diagnosed him is a new vet as I moved last year, so she’s only seen him once. The vet’s office insists that I bring him in if I want the Methcarbamol. The appointment on the 19th with the new vet I switched to a tentative integrative appointment with the vet that is familiar with IVDD and also does acupuncture. I have hopes that she will give me the Methcarbamol if needed/if I keep the appointment.
Rin is doing REALLY well (pain wise). He wants to run around so bad, no yelping, and the medicine only makes him somewhat lethargic. He tries to contain his enthusiasm when we take him out to potty, but I can tell he just wants to run. Of course, still on strict crate rest and have had to leash+harness him a few times to potty and he’s done well. He’s still getting used to essentially doing nothing all day and whines a little when the other dogs get to go out and play without him.
Overall going well!!
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Post by Diana & Rinzler on Sept 4, 2019 13:20:56 GMT -7
[revised diagnosis: Valley Fever, not IVDD] I want to thank you all for the help you were able to give us! After working with two new vets in the same office, they were able to determine he in NO WAY has IVDD. He actually has Valley Fever with a tiger of 1:128 (on the severe side). Valley Fever is a spore most common here in AZ sand also in the souther part of CA, it’s a spore in the dirt. As we found out, the tiger tests for it are commonly know for false negatives, sometimes multiple false negatives. It showing up in the neck area isn’t as common as limps and coughing that most dogs have. SO glad we were able to keep him comfortable while we got to this point thanks to all of your suggestions! Glad to know how amazing of a resource y’all are and I definitely was able to pass around some of your brochures/literature to a few different vet offices in the area to help spread awareness! Thanks again!! 💞 |
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Post by Romy & Frankie on Sept 4, 2019 13:28:22 GMT -7
I hope Rinzler makes a good recovery from Valley Fever. From what I read it is quite hard to diagnose.
Healing thoughts for Rinzler.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 5, 2019 8:05:18 GMT -7
Thank you Diana for the update. The right diagnosis means the right treatment can go forward. Best to Rinzler going forward. Thank you for helping to spread the word about Dodgerslist with our brochures.
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