|
Post by Howard on Aug 28, 2019 6:45:45 GMT -7
Pinched nerve Hi my name is Angie and my 12 yr old dachshund has a pinched nerve. I took him Saturday morning to the vet where they gave him a cortisone shot. They told me if he wasn’t better by Monday to start Tramadol. Well on Sunday he was bad and yelling in pain so i took him to the er. There they put him on 50 mg of gabapentin and 25 of Tramadol. [Moderator's Note. Please do not edit 17 lbs name of cortisone shot on 8/24 gabapentin 50 mgs 2x/day tramadol 25mgs 2x/dayno GI tract protector Pepcid AC on board with shot! ]I brought him home and he started acting really crazy. Panting and drooling. He would not calm down and relax. He hates his Kennel so i laid by him in the floor. He could always could walk and he shakes his head but after the quick turns of his head is when he yelps and starts going in circles and scratches the floor. Yesterday he started this whinnying and he hasn’t stopped. I have a call into the vet but i don’t know if his tummy hurts or he is in pain. He was always a whiner for treats but this is constant. He had 3 big BM’s yesterday and they were soft.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 7:21:10 GMT -7
Angie welcome to the Forum, sorry your boy is suffering with a disc episode. With your description about his head shakes and then pain, it seems as though the bad disc is in the neck. These are the most painful with the neck having to move when other parts of the body move. THEREFORE.... --- if this is indeed a neck disc an aggressive pain med and steroid approach is a must and should have started on 8/24! --- Extra things you can do at home to help with a neck disc (won't hurt to do if turns out to be a disc in the back): www.dodgerslist.com/literature/cervical.htm--- How to do the essential 100% strict rest required to get the disc to heal, different types of suites and how to set them up: www.dodgerslist.com/literature/CrateRRP.htm--- Emergency crate training strategies: www.dodgerslist.com/literature/EmergencyCrate%20Training.htmSTRICT rest 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! How much does your dog weigh? What was the name of the cortisone shot on 8/24?Talk with the vet over the phone to report the pain (so as not to risk more damage to the disc with a vehicle transport. --- Prednisone pilsl for at home given every 12 hrs. --- gabapentin would necessarily be Rx'd for promptly every 8 hrs to provide adequate med level round the clock, dose to dose pain relieve --- tramadol is often undermedicated in mgs (don't know your dog's weight so not able to comment. Tramadol also needs to be Rx'd for every 8 hrs. --- Methocarbamol needs to be added for the pain that stems from muscle contractions. This med would also be Rx'd every 8 hrs. -- Pepcid AC (famtoidine) is a must now, today, asap. One of the early red flag signs of GI tract (stomach & intestines) is loose stool. PLEASE, please take no chances! Proactive vets don’t wait til there is lip licking of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers, red or black blood in stool due to the extra stomach acids anti-inflammatory drugs cause. Pepcid AC (famotidine) blocks the production of acid. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours. Pepcid AC has a very limited potential for side effects. 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).
HEALTH ISSUES: “Mar Vista Vet reports: Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients.” marvistavet.com/famotidine.pml 100% STRICT crate rest 24/7 only out of the recovery suite for a very, very few footsteps at potty time is how the disc will heal and prevent further damage to the nerves in the spinal cord.Education is the key to IVDD! Our goal is to help you maneuver things that can be overwhelming with an IVDD diagnosis in caring for your dog. Getting quickly up to speed on intervertebral DISC disease helps you in understanding the why of what your vet advises and the ability to bring things to the table in working together to help heal the disc. You will be very amazed how quickly you can learn a lot about just one disease which a vet is not able to know in great detail for every single disease known to cats, dogs, birds, and many other species they treat.
Keep in mind the key word in the name of the disease is DISC. #1 Take a look so you can visualize just why the need to be strict about crate rest for the DISC is so important in preventing a surgery
#2 How/why meds are used while the DISC is healing. A good review of the many things the vet usually goes over about his diagnosis, the Rx’d meds, crate rest, other stuff that you may not have fully processed during that short vet visit.
#3 The very best thing you can do for YOU, the caregiver, and for your dog is to read and learn as quickly as you are able. Calm your mind by being “in the know” how long each the 4 phases of healing is expected to take. What treatments for which phase? At what point would a surgery be considered? This is the page to bookmark and return to in the next days to have a full understanding of the now and the future of living many happy years ahead with your IVDD dog. Here is the link to bookmark: www.dodgerslist.com/healingindex.htm
|
|
|
Post by Angie & Howard on Aug 28, 2019 7:24:37 GMT -7
He is 17 pounds. I’m not sure if what the shot of cortisone was.
It started 08/24/19 and that is where he got the shot of cortisone. Then they started 25mg of Tramadol on 9/25/19 at the emergency and 50g of gabapentin 3 times a day. I called his vet on [8/26/19 typo:] 9/26/19 and they cut the ▼Tramadol to 12 mg of Tramadol and kept the gabapentin the same. He is taking this morning and night so twice a day.He also added 25mg of ✙vermaxx [Deramaxx] once a day.
[Moderator's Note. Please do not edit 17 lbs name? of steroid cortisone shot on 8/24 ✙Deramaxx as of 8/26: 25mgs 1x/day No 5-7 day washout from cortisone!!! gabapentin 50 mgs 2x/day tramadol ▼12mgs 2x/day no GI tract protector Pepcid AC was on board with steroid shot! no sulcralfate was added with deadly switch to Deramaxx!!]
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 7:26:57 GMT -7
added 25mg of vermaxx once a day.
Please VERIFY!!!
If this drug is actually Deramaxx, your vet has just RX'd a DEADLY combo. STOP the Deramaxx at once!!!! The cortisol shot remains in the body for days. So with a NSAID (Dermaxx) added your dog is undergoing a double jepardy to his GI tract. Dogs have died from this
|
|
|
Post by Angie & Howard on Aug 28, 2019 7:27:16 GMT -7
He walks just fine and shakes his head when it’s like he has water in his ears but doesn’t cry. The only time he cries is if he is laying and gets spooked. That’s when he yells out in pain. This crying all day started [Aug 27, 2019 typo!]: 9/27/19. He freaks out in his kennel so i have to have him on the floor beside me in His bed with extra soft blankets
Sorry it was Deramaxx
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 7:36:41 GMT -7
Thank you VERY much for registering!!! Bookmark a thread to receive an email alert when someone has replied 1. Go to your Profile> Profile Edit > Notifications: checkmark BOOKMARKS + "instant" email 2. Next, find your dog's thread in the list and place a checkmark there, 3. Then use the ACTIONS button to select "bookmark"
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 7:41:58 GMT -7
STOP the Deramaxx AT ONCE!!!!! Your vet has subjected your dog to danger. Read the what the professional write in their quotes at the end of my post. CAll your vet and get an RX for sucralfate! Go to the grocery store and buy Pepcid AC (famotidine) ■ FDA: If you suspect a possible side effect to an NSAID, STOP giving the drug to your dog and call your veterinarian immediately! www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm196295.htm■ All NSAID package inserts carry this similar FDA required warning as for Previcox: "PREVICOX should not be given with other NSAIDs (for example, aspirin, carprofen, etodolac, deracoxib, meloxicam, or tepoxalin) or corticosteroids (for example, prednisone, cortisone, dexamethasone, or triamcinolone).." www.fda.gov/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/DrugLabels/ucm050105.htm■ The primary cause of adverse effects from NSAIDs is incorrect dosing (eg, concurrent use with corticosteroids or another NSAID, changing NSAID without a suitable washout).8 Washout period (dogs, 5–7 days 2 2. Guidelines for safe and effective use of NSAIDs in dogs. Lascelles BD, McFarland JM, Swann H. Vet Ther 6:237-251, 2005. 8. Systematic review of nonsteroidal antiinflammatory drug-induced adverse effects in dogs. Monteiro-Steagall BP Steagall PV, Lascelles BD. JVIM 27:1011-1019, 2013.
■ The use of nonsteroidal antiinflammatory drugs in combination with glucocorticoids increases the risk of life-threatening gastrointestinal hemorrhage. This combination of drugs should be avoided in all patients. app.vetconnect.com/5min/data/07400741.htm ■ It is also unacceptable to concurrently administer steroidal and nonsteroidal anti-inflammtory drugs (NSAIDs) to disc disease patients, as this combination increases the chances of severe gastrointestinal complications. It is important to realize that subclinical gastroduodenal ulceration is likely to be present in dogs with type 1 disk extrusions, even without the administration of potential ulcerogenic drugs (e.g., NSAIDs, glucocorticoids), so the use of such drugs should be minimized if at all possible. Curtis W. Dewey, DVM, ACVIM Neurology Cornell University. A Practical Guide to Canine and Feline Neurology 2nd ed Blackwell Publshing 2008 Chapt 10 "Myelopathies: disorders of the Spinal Cord"; By Curtis W. Dewey p331-332. • Let me be crystal clear right from the get-go. A steroid (aka: corticosteroid, glucocorticoid) should rarely be given at the same time as a non-steroidal anti-inflammatory drug (aka: NSAID) prescribed at an anti-inflammatory dose. This is a well-established pharmacologic principle, but for some reason, it is also one I see violated on an almost daily basis. With so many alternatives to help keep patients as comfortable as possible, I’m perpetually flummoxed by this choice of treatment. Thus I’m writing this blog post so pet parents are aware of this important issue and can be proactive advocates for their fur babies. Christopher G. Byers, DVM, DACVECC, DACVIM (SAIM), CVJ criticalcaredvm.com/a-potentially-lethal-combination/MOre info on the timing of sucralfate with Pepcid AC and with food. Full sucralfate info here: marvistavet.com/sucralfate.pml Sucralfate reacts with stomach acids to form a protective paste at the site of any ulcerations. ~Ideally give Sucralfate on an empty tummy at least 1 hour before feeding or 2 hours after feeding ~If possible, it should be given 30+ minutes prior to the administration of Pepcid AC. ~Give Pepcid AC 30minutes before Prednisone ~Give a steroid or a non-steroid anti-inflammatory drug with a meal. Pred could be given along with pain meds IF also due at that time.
|
|
|
Post by Angie & Howard on Aug 28, 2019 7:52:54 GMT -7
I don’t understand why my vet would put my dog i. Danger.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 7:59:42 GMT -7
Not all vets appreciate the danger of mixing the two classes of anti-inflammatory drugs— the steroid class with the non-steroid (NSAID) class. As the last vet I gave you a quote to ....he doesn't not understand why either and gives warning to pet owners to be aware. Your vet gave the cortisol shot (what is exact name of it?)? and your vet Rx'd the Deramaxx or was it ER who Rx'd Deramaxx. IF same vet did both, that shows he is not comfortable with IVDD. Non-aggressive use of pain meds, no stomach protection...all indicate the possible need to find a different vet who knows IVDD to support you. If not possible AND your vet is open to learning new things--- the things you learn from Veterianry profesisonals we point you to then you may be able to work with this vet. If not, I can tell you that it is like the difference from day and night to hire an IVDD knowelegeable vet to be on your dog's health care team. What trusting eyes our dogs have! Vets choose an anti-inflammatory during a disc episode to get painful swelling down in about 7-30 days. These powerhouse meds do wonders OR they can be dangerous. Vets who practice safe medicine and owners up to speed on medications make all the difference. Did you get all four questions right?
|
|
|
Post by Angie & Howard on Aug 28, 2019 8:09:34 GMT -7
I’m waiting to hear back what type of shot it was.
My vet gave me the deramaxx. He also reduced the dosage of the Tramadol because he said that was a lot to give him. The er vet also gave him a 50mg of gabapentin before we left on 9/25 8/25 at 4 and I called back at 7 because he was acting so weird and the told me to give him another gabapentin. I’m so stressed and so sad for my baby.
Yes 8/25. This is what a lack of sleep does
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 8:16:21 GMT -7
Tramadol is often WAY, WAY undermedicated as your vet is doing with Tramadol @ 12 mgs TWICE a day.
This info is not for you to be changing/self prescribing but so that you can work with your vet, bring up things for discussion.
The usual in controlling pain is to Rx Tramadol at the higher end of the mg range AND promptly every 8 hours. So for a 17lbs dog/7.71 kg dog the dose would be at minimum a full 50 mgs tablet of tramadol every 8 hrs to fully control pain...well then AND the other two kinds of pain meds would also need to be Rx'd for every 8 hrs. These pain meds (gabapentin, methocarbamol for muscle pain, and tramadol) all stay in the body a short time. Every twelve hours leaves the dog without enough to control pain. Thus pain can surface nearing the next dose and when the dog needs to move the head, move to go potty.
|
|
|
Post by Angie & Howard on Aug 28, 2019 12:53:48 GMT -7
I talked to the vet and I’m going to give him 25 mg of Tramadol 3 times a day. He is still whining a lot. I fed him with the last dose of Tramadol too. I don’t know why he would be whining so much. This just started yesterday 8/27
[Moderator's Note. Please do not edit 17 lbs name? of steroid cortisone shot on 8/24 Deramaxx as of 8/26: 25mgs 1x/day No 5-7 day washout from cortisone!!! gabapentin 50 mgs 2x/day tramadol ▲25mgs ▲3x/day no GI tract protector Pepcid AC was on board with steroid shot! no sulcralfate was added with deadly switch to Deramaxx!!]
I added a tsp of pumpkin too. I’m going to pick up some Pepcid ac and start that too. He walks fine but he just can’t lay down longer than 5 min. Poor baby needs to sleep.
|
|
|
Post by Romy & Frankie on Aug 28, 2019 13:32:28 GMT -7
Not being able to find a comfortable position is a sign that your doxie may be in pain. Are you seeing any other sign of pain? I am putting the signs of pain here for your easy reference; •restless, can't find a comfortable position •slow or reluctant to move much in crate such as shift positions •shivering-trembling
•yelping when picked up or moved •tight tense tummy
•arched back, ears pinned back •not eating due to painful chewing or in too much overall pain •head held high or nose to the ground. •looks up with just eyes and does not move head and neck easily. •holds front or back leg flamingo style not wanting to bear weight •not their normal perky selves
If you are seeing any of these other signs of pain in addition to the restlessness that is conformation that your baby is in pain.
Neck discs are particularly painful and adjustment of the pain meds may be needed. Sometimes three pain meds each working on pain differently are needed for complete relief. Methocarbamol is the medicine that works on muscle spasms that are often seen with neck disc issues. Please let your vet know that you are still seeing signs of pain and discuss adding Methocarbamol 3x/day.
I am very glad that you are getting the Pepcid AC. The last thing our IVDD dogs need is stomach problems. The dose for doxies is 5mg every 12 hours.
|
|
|
Post by Angie & Howard on Aug 28, 2019 13:55:53 GMT -7
He seems to have a tense tummy. I just wish he could get comfortable to rest. He wags his tail, walks fine and seems to be happy when he sees me. It’s when he gets spooked he does that awful yelp and then scratches at the floor and goes in circles. He hates his kennel and so i lay with him by his dog bed. He is never left alone.
|
|
|
Post by Romy & Frankie on Aug 28, 2019 14:12:06 GMT -7
A tight tense tummy in addition to his restlessness indicates pain. It sometimes takes a vet a few tries to get the meds exactly right because each dog is different. You will know the meds are right when he is showing no signs of pain within an hour of getting his pain meds and there is no pain between doses. Please call your vet and tell him your doxie is in pain. Pain will only slow the healing process. If you feel his problem is more stress related, you can speak to your vet about a sedative. Tramadol and Acepromazine are what we most commonly see prescribed.
There are also some natural calmers you can try.
Using an oral calmer in combination with a Pheromone diffuser. This seems to work best. It takes several days for these to start working - it isn't immediate, but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price.
Place a DAP pheromone diffuser at floor level where the recovery suite is.
Dogs: Adaptil (DAP) wall plug in diffuser 48ml
2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. Please keep us updated on how your baby is doing.
|
|
|
Post by Angie & Howard on Aug 28, 2019 15:59:25 GMT -7
Can Tramadol make a Doxie whine? I’ve read some places it can make them anxious
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 19:57:04 GMT -7
Is the whine the same sound as when the dog wants your attention?
|
|
|
Post by Angie & Howard on Aug 28, 2019 20:04:54 GMT -7
And this constant whining started yesterday.
He is fine if we are outside too.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 20:15:01 GMT -7
Angie, who is Helen. What we want to know is the name of your male doxie. What is his name?
Do consider Romy very good advice in helping your doxie be able to relax in his recovery suite with the calmers she listed out for you.
Be aware you might be inadvertently training for unwanted behavior. To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting. So anytime you see unwanted behavior try speaking in your dog's language so he understands to calm down. Turn your body sideways, avoid eye contact until he calms and settles down. Preferable is to start teaching what you do want before there is too much practice in doing the unwanted behavior. Anytime your dog is sitting or lying down quietly, give a reward of a calm loving "good sit/lie." Soon your dog will see he gets rewards by quietly sitting, etc.
|
|
|
Post by Angie & Howard on Aug 28, 2019 20:17:44 GMT -7
Sorry I signed in on my other dog Helen who had disc issues last year. My male dog is Howard and Howard is the one with the pinched nerve.
It seems to me that when the Tramadol will be wearing off is when he calms down. That’s why I asked if it could be that.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 28, 2019 20:27:55 GMT -7
Tramadol can cause anxiety.
If he still has time he yelps, then the pain meds are not yet right. There is no pain med on board to address the very typical kind of pain that comes with a disc epsiode- methocarbamol every 8 hrs. Did you discuss with your vet. It often takes a 3-way combo of pain meds each addressing a different source of pain. Also some of these meds when used together work synergistically....that is the three to gether are far better than one by itself.
Which anti-inflammatory is he now on? The steroid prednisone pill which is compatbile or the non compatible Deramaxx?
cortisol shot --what is exact name of it?
Is Pepcid AC on board twice a day now....how many mgs are you giving?
|
|
|
Post by Angie & Howard on Aug 29, 2019 10:03:35 GMT -7
His vet told me to up his ▲tramadol to 25 to even 50 mg every 6 to 8 hrs. I give him deramaxx once a day and gabapentin twice daily.
[Moderator's Note. Please do not edit 17 lbs name? of steroid cortisone shot on 8/24 Deramaxx as of 8/26: 25mgs 1x/day No 5-7 day washout from cortisone!!! gabapentin 50 mgs 2x/day tramadol 25mgs ▲4x/day (with option of 50mgs 3x/day) no GI tract protector Pepcid AC was on board with steroid shot! no sulcralfate was added with deadly switch to Deramaxx!!]
His vet said as long as he is eating and drinking( which he eats a lot) I don’t need to worry about taking the Pepcid. Today he hasn’t whined as much but did have one yelping episode in his kennel when he woke up in the night. I have a call in for a muscle relaxer.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 29, 2019 19:25:23 GMT -7
Angie, you can help us with less back and forth quesitons by reporting how often you are now actually giving Tramadol 25 or 50 mgs? Every 6 or every 8 hrs. All anti-inflammatories can damage the stomach. Proactive vets don't wait til there is nausea, vomit, diareah leading to serious bleeding ulcers from the extra stomach acids Deramaxx causes. Get at the grocery store but FIRST do ask your vet in this very, very particular way: Is there a medical/health reason my dog may not take Pepcid AC (famotidine)? Doesn’t need it, we wait til there is problem…are NOT answers to your question! Understand your pet's meds, knowledge IS an important safety factor: 1) www.1800petmeds.com/Famotidine-prod11171.html and 2) marvistavet.com/famotidine.pmlHave you asked for Gabapentin every 8 hrs to provide it at a good level through out the day that every 12 hrs does not?
|
|
|
Post by Angie & Howard on Aug 30, 2019 12:42:31 GMT -7
25 mg of ▲ every 6 hours 50mg of gabapentin every 12 hrs And a half a veramaxx once in the morning (Sorry Deramaxx)
He just won’t get comfortable and sleep. They won’t give him a muscle relaxer. He eats, drinks and potty’s fine.
[Moderator's Note. Please do not edit 17 lbs name? of steroid cortisone shot on 8/24 Deramaxx as of 8/26: 25mgs 1x/day for ? days then test stop for _pain/_neuro gabapentin 50 mgs 2x/day tramadol 25mgs ▲4x/day (with option of 50mgs 3x/day) no GI tract protector Pepcid AC was on board with steroid shot! no sulcralfate was added with deadly switch to Deramaxx!!]
|
|
|
Post by Romy & Frankie on Aug 30, 2019 13:22:22 GMT -7
I am sorry that Howard can not get any rest. Did the vet say why he won't prescribe a muscle relaxer like Methocarbamol? Muscle spasms are seen fairly often with neck disc problems. Did the vet okay the gabapentin for every 8 hours? Have you had a chance to try any of the natural methods I suggested. You can also explain to the vet that Howard cannot settle to sleep and ask for a mild sedative. You need sleep if you are going to be able to continue providing good care for Howard. Have you started giving Howard the Pepcid AC? Dogs cannot tell us when they start to become nauseous or their tummy starts to hurt. We only know this when we see diarrhea or lack of appetite. Once we see these signs, damage has already started. That is why we urge you to ask the vet if there is a medical reason for Howard not to take Pepcid.
I learned for myself that this approach works. When Frankie was taking an anti-inflammatory I asked the vat about Pepcid and my answer was also it is not needed. But I had been reading Dodgerslist and the next time I asked if there was a medical reason he should not take Pepcid. This time the answer was no. I went to the drugstore, bought the Pepcid AC and gave it to Frankie. I felt better knowing his stomach was getting protection.
|
|
|
Post by Angie & Howard on Aug 30, 2019 13:34:39 GMT -7
His vet actually said that he didn’t really believe in the gabapentin but to only do it twice a day. He said he didn’t need a muscle relaxer. I asked Howard vet yesterday also about his stomach being upset and he said I can give him ✙metronidazole that O give him when he gets colitis and that will help protect his gi tract.
[Moderator's Note. Please do not edit 17 lbs name? of steroid cortisone shot on 8/24 Deramaxx as of 8/26: 25mgs 1x/day for ? days No 5-7 day washout from cortisone!!! gabapentin 50 mgs 2x/day tramadol 25mgs ▲4x/day ✙metronidazole (antibiotic) ? mgs ?x/day no GI tract protector Pepcid AC was on board with steroid shot! no sulcralfate was added with deadly switch to Deramaxx!!]
I’m going after work to get him some calming chews at the store. My dad lays with him all day long and pets him.
|
|
|
Post by Romy & Frankie on Aug 30, 2019 13:55:19 GMT -7
Your Dad is great. Having someone stay close to Howard will help his crate rest go more easily. I hope the calming chew will help Howard (and you) get some sleep. Is Howard showing any signs of pain now? Metronidazole is an antibiotic. It does not suppress stomach acids caused by all anti-inflammatories. You can read about it here: www.marvistavet.com/metronidazole.pmlMetronidazole should be taken with food.
|
|
|
Post by Angie & Howard on Aug 30, 2019 14:08:09 GMT -7
He walks around fine, goes potty, shakes his head and doesn’t whine too much. He just can’t get comfortable laying down. He wi lay for a few min and then gets up
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Aug 30, 2019 17:17:24 GMT -7
Not being able to get comfortable IS a sign of pain. It is prudent to act like a painful disease is a painful thing. Being in pain actual impedes the healing process not to mention how uncomfortable it is for the patient. Dodgerslist sides with Dr. Downing. Robin Downing, DVM, CVA, DAAPM is one of only four veterinarians in the world to hold the Diplomate credential in the American Academy of Pain Management - the largest interdisciplinary pain management organization in human medicine: " It is always better to use a multi-modal approach to pain management." And we side with the World Small Animal Veterinary Association (WSAVA) guidelines as well: " We can’t always know that our patient does hurt, but we can do our best to ensure that it doesn’t hurt" www.wsava.org/WSAVA/media/PDF_old/jsap_0.pdf Scroll down for table of contents References to treating pain for a known painful disease "One of the psychological curiosities of therapeutic decision-making is the withholding of analgesic drugs because the clinician is not absolutely certain that the animal is experiencing pain. Yet the same individual will administer antibiotics without documenting the presence of a bacterial infection. Pain and suffering constitute the only situation in which I believe that, if in doubt, one should go ahead and treat."1 Davis LE. Species differences in drug disposition as factors in alleviation of pain. In: Kitchell RL, Erickson HH, Carstens E, eds. Animal pain—perception and alleviation. Bethesda, Md: American Physiological Society, 1983:175. ==== Jessica Vogelsang, DVM: It wasn’t that long ago when people assumed pets didn’t feel pain as acutely as humans did. Some even thought that a little pain was good for a pet because it kept them from overdoing it during recovery from a surgery. It was a misguided approach, and modern veterinary medicine no longer works that way. Now, veterinarians are guided by the principle of “assuming pain.” That is, if a pet is experiencing something we know to be painful—an injury, a surgery, certain medical conditions—we should give a pet pain medication even if he or she isn’t outwardly crying or limping.====
Veterianary Pharmacist explains to veterinarians: "Combining NSAIDs with other analgesic such as opioids, tramadol, gabapentin, and amantadine result in additive to synergistic analgesic effects and more effective pain control. NSAIDs, anesthesia, and the kidneys: What they are not telling you (Proceedings) Aug 01, 2010 By Butch KuKanich, DVM, PhD, DACVCP .http://veterinarycalendar.dvm360.com/nsaids-anesthesia-and-kidneys-what-they-are-not-telling-you-proceedings last accessed 3/18/16==== Neuro Surgeon Dr. Galle explains to veterinarians at a conference: "...spinal pain should also be treated appropriately with pain medications (opiates and gabapentin), anti-inflammatory drugs, and muscle relaxers (valium and methocarbamol). Tramadol, butorphanol, and fentanyl transdermal patches can all be effective treatments for the patient at home... Gabapentin...can be very useful in treating spinal pain. Anti-inflammatory drugs (corticosteroids and non-steroidals) are useful whenever an inflammatory process is causing pain. These are most often used when treating disk herniations and meningitis. These drugs should not be used in combination with one another and appropriate washouts are needed when switching from one drug to the other. Cervical disk herniations can cause muscle spasms which can be painful. Diazepam and methocarbamol can help relax these muscles and should be used if muscle spasms can be seen or palpated." Jared B. Galle, DVM, Diplomate ACVIM (Neurology). Michigan Veterinary Medical Association Proceedings 2014. QUESTIONS- For how many days is he to take Deramaxx? - Metronidazole (antibiotic) ?mgs is each dose AND how often do you give? - Is there another vet in your town, next town where you can get a 2nd opinion from? There is no shame on anyone. People will commonly get a 2nd opinion for themselves. Howard seems like he deserves a 2nd opinon too: - When will Pepcid AC be on board to suppress acids that Deramaxx causes? Antibiotic metronidazole kills bacteria.
|
|
|
Post by Angie & Howard on Aug 30, 2019 17:41:58 GMT -7
[Editor's NOTE. Best to always report how often you actually give a med and the dose you actually give. THANKS BUNCHES!! Post your updated info in a new post, this one has already been read and marked for important points]
He can have ▲gabapentin [WHICH is now actually given?]: 2 to 3 times a day now and they are 50 mg. Metronidazole is 250 mg twice a day The Dermaxx is 25mg and it’s once a day and I had enough for 7 days so Monday on Labor Day I’ll be out but the vet said just to call for more meds. Both the er vet and my vet said no to the Pepcid so I’m going to just give it to him starting tomorrow. I bought some calming chews and just gave him one. I put a small pillow under his neck because it seems that he can’t get comfortable to lay down. I just with someone would give me Methocarbamol
[Moderator's Note. Please do not edit 17 lbs name? of steroid cortisone shot on 8/24 Deramaxx as of 8/26: 25mgs 1x/day for 7 days 9/2 test stop for _pain/_neuro gabapentin 50 mgs ▲3x/day tramadol 25mgs 4x/day metronidazole (antibiotic) 250 mgs 2x/day no GI tract protector Pepcid AC was on board with steroid shot! no sulcralfate was added with deadly switch to Deramaxx!!]
|
|