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Post by Nancy & Milly on Aug 24, 2023 12:53:52 GMT -7
[Original subject line:Steroid vs meloxicam ] ☆ 1 Is there still currently pain? ☐ reluctant to move much in crate such as shift positions or slow, ginger movements ☐ Arched back ☐head held high or nose to the ground ( sometimes) ☐Not their normal perky selves? ☆ 2 12.5 pounds 7 y.o.B.. steroid…. Started - August 12th, 2023- Finished -August 17th Date of steroid taper? - August 14thCurrent meds: Methocarbamol orl liquid 100 mg - ( 3 times a day ) Gabapentin 200mg - quad tab (3 times a day ) Meloxicam 1.5 mg/ml ( 1 time a day ) Spine Lithe 500 mg ( 1/2 tablet - twice a day ) Tramadol HCI 50mg 1/2 tab - every 8 hours
[MED LIST/HISTORY- Moderator's Note. Please do not edit
12.5 lbs 7 y.o.
slightly wobbly
CT scan 8/21
specialist appt 9/5
meloxicam long term and as of 7/6: for ? days, then date of STOP? due to pain
Prednisone as of 8/12 for 2 days, then 8/17taper : 8/9+ 8/17 pain
Meloxicam resumes as 8/18: 1.5 mg/ml 1x/day No washout, no double GI protections!
methocarbamol formula ?mgs/mL: 100mgs 3x/daygabapentin 200: ? mgs 3x/day
traMADol 25mgs 3x/day
spine Lithe 250mgs 2x/day
Millie needs GI tract protector, Pepcid AC, on board for duration of any antiiflammaory meloxicam or a steroid! ]C.. PEPCID AC: Phrase a simple question that you expect a simple "yes "or "no" to it. Does my dog have any health issues to prevent use of Pepcid AC (famotidine)? no (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).
(NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. www.1800petmeds.com/Famotidine-prod11171.html )☆ 3 ⚠️☠️Not eating, vomit, loose stool, bleeding ulcers, red or black blood in diarrhea.
☆ 4 dachshund, Milly. Nancy ☆ 5 diagnosis disc problem. DVM? yes -- specialist surgeon waiting to see - Sept 5th, 2023 ☆ 6 What was the date you saw the vet for CONSERVATIVE treatment? July 6th☆ 7 bladder control? YES
My pup had lower back issues over a year ago ( Feb 2022 ). We went the conservative route with meds and acupuncture. She recovered. On the evening July 5th, 2023, she cried out in paidn. ( Never had done this before ) . Called vet, he had me give her another dose of Gabapentin . Took her in the next morning.
[7/6] Vet seem to think he "tweak" her neck. Added the methocarbamol to her daily meds of Gabapentin & Meloxicam [?]. July 12, went to acupuncture dr, again on August 4, doctor thought she was doing better and we could back of the muscle relaxers. She was going out of the country until the end of the month. August 9th, Milly starting hanging her neck again and would barely moved.
B ack on muscle relaxers and he did a cold laser treatment on her. August 11th, still no relief. I asked about using Prednisone instead of the Meloxicam. He agreed, this could help. Still didn't think she needed a MRI/CT scan, she wasn't knuckling her feet etc. August 15th, another cold laser treatment, she seemed to be feeling better. August 17th, on the last [prednisone] steriod pill, Milly starting crying out in pain again. Took her back to the vet, they gave her a shot of Butorphic 10 mg/ml for fast releif. They added Tradadol HCI 50 mg to her pain meds. Started her back on Melocisam on Friday, August 18th. Milly had a CT Scan on MOnday , August 21, it shows damage in her C4-5 disc.
Referring us to neurologist. The appt is not until September 5th.We go tomorrow [Fri 8/25] back to regular vet to discuss pain management ( my request ). My question is, Milly seem to feel so much better while on the steriods, instead of the meloxicam. What are your thoughts on using the steriods and stopping the meloxicam  Do you know of any dogs with IVDD that uses this as a long term medicine, with proper monitoring from the vet ? I'm going to hear what the neurologist has to say, but I really do not want to go the surgery route. Milly is a little wobbly at times [Front or rear legs?], but I have her on strict rest, carrying her outside to potty.
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Post by Romy & Frankie on Aug 24, 2023 13:52:30 GMT -7
Welcome to Dodgerslist, Nancy. We are glad you’ve joined us all. We’ve got valuable information we’ve learned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you! Learn more about us and how we team up with veterinarians: dodgerslist.com/about-team-dodgerslist/
The most important thing you can do for Milly right now is Strict crate rest. The crate rest must be Very Strict. We always use the example of a broken arm. A broken arm is put in a cast to limit movement and allow the bone to heal We can't put a cast on a dog's spine so we use the crate to limit movement and allow the disc to heal. The dog should be in the crate 24/7 for 8 weeks, out only for necessary vet visits and pottying.
STRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times
Carry Milly to and from the recovery suite to the potty place and then allow a 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 a minimum as you stand in one spot.
Information about crate rest is here: www.dodgerslist.com/2020/05/14/strict-rest-recovery-proc
Can Milly wobbly walk? move her legs at all? wag her tail when you specifically do some happy talk?
I am trying to understand the timeline of Milly's IVDD episode. The first time you saw the vet for this episode was on July 6. Was she taking any meds from July 6 to the time the steroid started on August 12?
Do you know why the vet changed from a steroid type of anti-inflammatory to Meloxicam, an NSAID type of anti-inflammatory? The steroid type of anti-inflammatory is a stronger medicine.
We have information on these medicines at the link below: dodgerslist.com/2020/04/18/steroids-vs-nsaids
Your Milly is showing signs of pain since she is reluctant to move, has an arched back and is reluctant to lift her head. Please let the vet know right away the signs of pain you are seeing. The pain meds may need to be adjusted.
Reluctance to lift the head is often a sign of a neck disc issue. Did the vet mention Milly's neck as an area of concern? We have tips for helping during a neck disc episode at the link below: dodgerslist.com/2020/05/05/cervical-care-tips
All anti-inflammatories, like Meloxicam, cause excess stomach acid which can lead to serious stomach damage. To help prevent this damage it is important that a stomach protector like Pepcid AC is used. Our IVDD dogs have enough to deal with without running the risk of stomach problems.
Milly is currently on Meloxicam. When was it started? For how long was it prescribed?
It is very scary when our dogs have IVDD. It becomes less so when we learn all we can about the disease. We have more information on our main website: www.dodgerslist.com
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Post by Romy & Frankie on Aug 24, 2023 14:29:19 GMT -7
My apologies, Nancy. I posted without seeing your second post. I am preparing a response to that now.
Steroid types of anti-inflammatories are stronger than NSAIDs. If Milly showed signs of pain when the steroids ended, then that type of medication works better for her. It can take up to 30 days on the full dose of the anti-inflammatory to relieve all the swelling in the spine. For steroid meds, a taper is usually tried after about 7 days. Many dogs taper more than once before the swelling and therefore pain is gone.
Was Milly already taking Meloxicam and gabapentin prior to this episode?
It can be dangerous to switch from a steroid type of anti-inflammatory to an NSAID type without a 5-7 day washout where neither type of medicine is in the dog's system. The package insert of all NSAIDS have an FDA warning that they should not be given along with steroids. This is done to protect against double jeopardy of stomach acids. Stopping the steroid on Aug 17 and starting Meloxicam on Aug 18 means no washout was done. If the vet thinks it is an emergency to make this switch, the safest thing to do is to double protect the stomach with not just Pepcid AC, but adding Sucralfate, a prescription from your vet.
Please speak to your vet about this as soon as you can.
Sometimes a consultation with a board certified neuro (ACVIM) or ortho (ACVS) is not for surgery if it is not time nor an option for the family. The consultation would be because the specialist would be very experienced in treating IVDD medically. Some regular vets do not have this experience.
Since Milly is still walking, only a little wobbly, she would be a good candidate for conservative treatment.
During an IVDD episode, transport can be a danger of too much movement of the spine. Risk vs. benefit for the acupuncture and laser therapy should be weighed for dogs with little to mild neuro diminishment.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,610
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Post by PaulaM on Aug 24, 2023 19:20:02 GMT -7
Nancy, it seems that actually you were not doing the STRICT rest with so many trips in for acupuncture.
If a surgery is not an option for whatever reason, then you can try real true STRICT rest. IF you must have accupuncture, then hire a mobile vet to come to your house.
For how long has Meloxicam been a "daily" med? What is the reason?
Prednisone was only given for a 2-day course and then it was tapered. Probably not long enough to get the swelling gone. And then their were trips in to the vet where there was a potential for too much movement the neck/back.
What is the methocabamol formula from the bottle. Might be written ?mg/mL
How many mgs do you actually give gabapentin 3x/day?
The vet has room to move up in dose on traMADol from a low of 25mgs 3x/day
With all these switches from meloxicam to pred and then back to meloxicam.... WHY???
Why was the stomach not protected by a 4-7 days washout or either double protecting the stomach with not just the one usual Pepcid AC (famtodine) but a 2nd called sucralfate?
Are you currently reporting all these GI signs? ⚠️☠️Not eating, vomit, loose stool, bleeding ulcers, red or black blood in diarrhea.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,610
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Post by PaulaM on Aug 24, 2023 19:25:34 GMT -7
You ought to be able to discuss on the phone about med adjustments. Again each trip into the vet should be only for the most urgen of things. Things like med adjustments are done on the phone by vets who know their IVDD.
which legs are wobbly... front or rear legs?
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Do you know of any dogs with IVDD that uses this as a long term medicine, with proper monitoring from the vet ? 
