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Post by Tina & Ava on Apr 23, 2024 14:53:48 GMT -7
[Original subject line:Newbie - Ava - just diagnosed - IVDD ]
Hello. Hope I’m in the right spot! My name is Tina, I am Ava’s mom. Ava is a 4 y/o female French Bulldog. I was just given her IVDD diagnosis on [4/19] Friday of last week. Her physical symptoms
Started on Tuesday, took her to her vet on Wednesday, back to emergency vet on Friday which is when she was diagnosed. She is 23 lbs. and has lost 2 lbs since this started. Her vet has her on 500 mg Methocarbamol 3X daily, 300 mg Gabapentin 3X daily, 10 mg Prednisone 1 tab every 25 hrs for 5 days then .5 tab for 5 days, .25 tab for 5 days until gone. Emergency vet put a fetanyl patch on her for 5 days which gets taken off tomorrow. She is also on 5.4 mg Apoquel for her severe allergies which she is not scratching but vet recommended I still give to her in case she is still feeling the discomfort from the allergies.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
23 lbs 4 y.o
Prednisone as of 4/19: 10mgs 1x/day for 5 days, then 4/24 TEST TAPER for _pain? _neure?
Methocarbamol 250mgs 3x/day
Gabapentin 300mgs 3x/day
fetanyl patch exp 4/24
Apoquel 5.4mg for allergies
Ava needs GI tract protector, Pepcid AC, on board for duration of Prednisone]
I was taking her outside to potty. Lifting up with a towel as a sling. Before Friday, I was just holding her up but emergency vet recommended towel. I’ve since bought a sling. Now I don’t bring her out at all, I just let her release herself on a potty pad. She has been eating well but not drinking as well last 2 days. I’ve been giving her water from A syringe for a week. She was dehydrated and given fluids yesterday [2/22].
I started her on laser therapy and she has had 2 treatments and goes for her 3rd tomorrow. I have noticed her anal area is red and has some blood coming out. I read that is a concern. She has been in a large bed. Whenever I transport her anywhere, I keep her in the bed but unfortunately early on I did not. I just received a pet stroller for her so I will use that to transport her. I have to bring her to work with me because I am the only one home most of the week and have limited support so I haven’t been leaving her alone.
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Post by Romy & Frankie on Apr 23, 2024 15:18:01 GMT -7
Welcome to Dodgerslist. 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:
Blood in the anal area is a Very serious matter. I cannot stress this enough. All anti-inflammatories, like pred, cause excess stomach acid which can lead to serious stomach damage. To help prevent this damage, a stomach protector like Pepcid AC is used. The blood in the anal area indicates that some stomach damage has already occurred. Not eating or drinking also indicates this. When there is already damage, Pepcid AC is not enough. A second medicine, Sucralfate is needed. Sucralfate is a sort of bandage for the damaged area. It also accumulates healing tissue factors in its bandage; it not only protects the damaged area, but actively assists in the healing process. Sucralfate will require timing with other meds. Read about Sucralfate here:
Sucralfate is a prescription medicine. Please contact your vet right away and tell him what you are seeing. Ask about the Pepcid AC and Advocate for a Sucralfate prescription. If you cannot reach your vet right away, and you are certain Ava does not have any kidney, liver or heart health issues, start Pepcid AC today and keep your vet in the loop as soon as possible. Pepcid AC can be purchased in any drugstore or pharmacy.
The usual dose of Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Apr 23, 2024 15:56:14 GMT -7
Tina, let us know that by phone ( to avoid a risky transport into a vet) when you have both the Pepcid AC (famotidine) from grocery store and the RX item sucralfate on board. Also tomorrow 4/24 is the date that the 5-day course of Prednisone is to taper. Your job is to monitor to find out if any pain surfaces indicating pred has not had enough time to get all the swelling gone. Usually pain meds are stopped on the begin of the Pred taper to allow you a quick and accurate assessment of pain. Let us know which your vet wants full stop or backing off of the pain meds.
Rule of thumb: pain = swelling= another course of steroid
+ all pain meds, Pepcid AC back on board. NOTE: Always have a plan B in place with the vet prior to a prednisone test-for-pain taper on what you should do should pain surface. Have enough meds on hand til the vet reopens. Should pain re-surface over a weekend or evening when the Vet is closed, a plan B is free and an ER visit is expensive. Learn all about how prednisone is used during a disc episode so you are "in the know" and best able to communicate and understand your vet. LINK ADDED: ==> dodgerslist.com/2020/04/18/steroids-vs-nsaids/ |
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Post by Tina & Ava on Apr 24, 2024 6:54:36 GMT -7
I’ve ordered the Pepcid AC to be delivered today. Ava is going for laser therapy today. I’ve contacted both her vets regarding the prescription sulcrafate. Waiting to hear back.
Ava is eating really well. I haven’t been giving her the normal volume of food because I was worried maybe it was too much with lack of movement. Should I be feeding her more since she is definitely eating well? Can you confirm the best volume of food to give her at this time?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Apr 24, 2024 7:29:30 GMT -7
Tina, Let us know which your vet wants full stop or backing off of the pain meds.
Rule of thumb:
pain = swelling=
another course of steroid
+ all pain meds, Pepcid AC back on board.
Today, 4/24, is the date that the 5-day course of Prednisone is to taper! Your job at home is to assess for pain. You can NOT do a good job when pain meds are on board. Generally vets stop the pain meds on the date the pred taper starts.
Now is not the time for diets. The body has many repair jobs to do and need quality optimal nutrition. Feed same amt as before the disc episode. Cut out all hi-calorie snacks..... especially the commercial store bought ones.
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Post by Tina & Ava on Apr 24, 2024 8:26:12 GMT -7
Ok good to know. I’ve never given her store bought treats unless the “healthy” fruit kind. I always give her fruit and veggies (specifically blueberries for treats). Also, I gave her chicken broth because she wasn’t drinking water well. Not as much as she needed to. Is this ok? She is allergic to chicken so I will get vegetable broth but in the meantime I felt keeping her hydrated was more important.
She is secreting an excess amount of fluids this morning and seems to be in discomfort. Anything else I should do about this other than what has been instructed?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Apr 24, 2024 12:59:21 GMT -7
What does secreting fluids mean exactly. Describe what you observe.
Correction: You can NOT do a good job when pain meds are on board to assess for pain. Generally vets stop the pain meds on the date the pred taper starts. Update us on the pain meds gabapentin and methocarbamol (current dose in mgs and times per day). Will they be stopped today?
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Post by Tina & Ava on Apr 25, 2024 1:40:42 GMT -7
Hello. First off, thank you for all your help so far. I'm so grateful...
Yesterday was rough [4/24]! Ava was very restless through the night and wouldn't sleep and cried almost all night. She didn't want me to leave her sight but seemed better when I comforted her. I took her to her 3rd laser therapy treatment at the vet on 4/24. She panted a lot and was very stressed and showed signs of feeling pain and distress. The vet added 50 mg ✙Tramadol to her meds to be taken every 8 hrs for pain.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
23 lbs 4 y.o
Prednisone as of 4/17:10mgs 1x/day for 5 days, then 4/22 TEST TAPER for 4/24pain _neuro?
as of 4/24: 10mgs 1x/day for 3 days, then 4/28 TEST TAPER for -_pain _neuro
Methocarbamol 250mgs 3x/day
Gabapentin 300mgs 3x/day
✙traMADol 50 mgs 3x/xay
fetanyl patch exp 4/24
Apoquel 5.4mg for allergies
Clintabs (clindamycin ) as of 4/22 eye and belly infection
✙Sulcrafate 500mg 2x/day one hour before meds in a water slurry
✙Pepcid AC ?mgs 1x/day on board for duration of Prednisone]
Med list:
4/24/24 - ✙Pepcid AC/Famotidine - .44 tablet 30 min before Prednisone - 1x day
4/24/24 - Tramadol - 50 mg - To be taken every 8 hrs for pain
4/24/24 - ✙Sulcrafate - 1 gm - 1/2 tablet every 12 hrs one hour before meds in a water slurry
4/22/24 - ✙Clintabs (antibiotic) - 150 mg - 1 capsule every 12 hrs (for possible infection forming on her belly and left eye
4/17/24 - Prednisone 10mg - 1 tablet every 24 hrs for 5 days, .5 tablet once daily for 5 days, .25 tablet every other day until gone.
4/17/24 - Gabapentin 300 mg - 1 capsule 3x daily every 8 hrs for pain
4/17/24 - Methocarbamol 500 mg - 1/2 tablet 3x daily every 8 hrs
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Apr 25, 2024 11:28:40 GMT -7
Tina, honestly it is difficult to know what actually is going on with Ava. Accurate dates are useful.....use the date rather than Tuesday, last week, etc. when posting. Thanks for understanding
Here is how prednisone is usually handled so that one clearly without confusion knows what caused pain.
--- the pred taper (corrected to 4/22 start) is the time to monitor for pain
--- at home laser so that a risky to the disc transport is avoided. For Ava, was there too much movement that caused her pain OR was it the laser treatment that caused pain?
--- if pain on the pred taper, then it is not time to be in the taper. With sucralfate + pepcid AC FINALLY on board pred could continue if pain was due to disc damage.
--- Disc damage would also mean restarting the 8 week recount.
--- Vet adding traMADol would be appropriate for a set back on her disc issue. But not appropriate for pain due to laser
-- So Ava has unknown cause of pain due to a number of different things allowed that could contribute to pain.
-- Vet is treating with meds (added traMADol) as if disc related
---However, if pain is disc related it would not be time to be in a taper.
It would, instead, mean another course or pred to get all the swelling around the cord down.
Pred taper days are no longer working on painful swelling around the spinal cord now.
Does the traMADol now on board since 4/24 provide round the clock comfort now?
What did the vet explain the reasoning about continuing on with pred, adding traMADol?
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Post by Tina & Ava on Apr 25, 2024 23:26:24 GMT -7
Ava had a much better day today! I believe all you advised helped! Because today [DATE 4/26] she is a different dog than she has been the past few days and is showing a lot more signs of being herself. I did provide the dates as asked??
The vet put her on the Tramadol based on what we saw yesterday [date 4/25] which seemed she was in pain. We were concerned it was due to the fentanyl patch coming off which came off 4/24/24. Today 4/25/24, no evident pain.
I'm sorry but I forgot to include that on 4/24/24, the vet recommended staying on the full dose of the prednisone rather than half a tablet based on her current condition at the time. Hoping she continues to improve. Thank you again.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Apr 26, 2024 10:19:12 GMT -7
Tina, please fill us on on the missing Pred information.
Prednisone is the single most important of the IVDD meds. THE workhorse med, Prednisone, deals with inflammation in 7-30 days excluding any taper days.
The other meds are supportive to mask pain (methocarbamol, gabapentin and traMADol), protect the stomach (sucralfate and Pepcid AC)
What are the missing details of the 4/24 pred prescription?
Prednisone as of 4/24 10mgs tab:
? mgs each dose
how many times/day dosed?
For how many days? is the course, THEN another taper test for pain and neuro
Very pleased to hear things are going much better for Ava
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Post by Tina & Ava on Apr 30, 2024 22:50:58 GMT -7
Hello. Ava showed a lot of progress over the weekend! She was moving more, sat up, was waving her paws, ate and drank by herself for the first time in over a week. She was showing signs of her personality again and seemed happy and painless. She is still doing well. I found a soft sided crate for her and still limit her movement. She seems to love her new little "house."
As for the predisone, last week on 4/24/24 when her condition seemed to worsen, the vet recommended going back to a full tab of prednisone. I was giving her full tab until Monday, 4/28/24. I took Ava for her 5th laser therapy appt and asked the vet to advise on the prednisone based on her improved condition, she said to go back down to 1/2 tab so that is where I am currently. 1/2 tab once a day.
All other meds the same except for no more Tramadol. I gave it to her until it ran out and since she is showing no signs of pain, I didn't get it refilled.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
23 lbs 4 y.o
Prednisone as of 4/17:10mgs 1x/day for 5 days, then 4/22 TEST TAPER for 4/24 pain _neuro?
as of 4/24: 10mgs 1x/day for 3 days, then 4/28 TEST TAPER for -_pain _neuro
Methocarbamol 250mgs 3x/day
Gabapentin 300mgs 3x/day
Apoquel 5.4mg for allergies
Clintabs (clindamycin ) as of 4/22 eye and belly infection
Sulcrafate 500mg 2x/day one hour before meds in a water slurry
Pepcid AC ?mgs 1x/day on board for duration of Prednisone]
Ava goes for her 6th laser therapy appt today Wed 5/1/24.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on May 1, 2024 12:16:39 GMT -7
Tina, this is good news to hear on the 4/28 pred taper, Ava is showing no signs of pain. You do know that is not an accurate read about pain? There still 2 pain meds on board blocking information if all painful swelling is really gone or not.
What date will Methocarbamol and gabapentin be stopped?
MED LIST/HISTORY-
23 lbs 4 y.o
Prednisone as of 4/17:10mgs 1x/day for 5 days, 4/22 TEST TAPER for 4/24 pain _neuro?
as of 4/24: 10mgs 1x/day for 3 days, 4/28 TEST TAPER for _pain _neuro
Methocarbamol 250mgs 3x/day
Gabapentin 300mgs 3x/day
Apoquel 5.4mg for allergies
Clintabs (clindamycin ) eye and belly infection
Sulcrafate 500mg 2x/day
Pepcid AC ?mgs 1x/day on board for duration of Prednisone]
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Post by Tina & Ava on May 1, 2024 23:12:09 GMT -7
Yes, I do know and I'm sorry that I worded that wrong. What I meant was, before even with the pain meds, she still seemed to be experiencing pain and discomfort whereas now she is not. On 5/1/24, I had the Prednisone and Methocarbamol refilled with the vet.
She also had another laser therapy treatment. I do notice that a few times I haven't given the Pred and Metho right within the 8 hr time frame and she didn't seem to be experiencing pain and discomfort. So I feel that is a good sign...Everyone at the vet's office is extremely excited about her progress so far in just a short time. She is still being crated full time and I am limiting her movement as much as possible.
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Post by Romy & Frankie on May 2, 2024 13:10:50 GMT -7
I am happy to hear that Ava is feeling so much better. Strictly limiting her movement by crating is very important, so I am glad that she likes her little “house”.
When you had the prescription refilled for the pred, were the instructions to continue on the 1/2 tab once daily? What date will Methocarbamol and gabapentin be stopped? |
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Post by Tina & Ava on May 2, 2024 23:10:06 GMT -7
Yes, the instructions were to continue on the [taper dose] Prednisone [10mg tablet] 1/2 tab once daily and they have not said when Gabapentin and Methocarbamol will be stopped. I will ask them on Friday 5/3/24 when I take her for laser therapy.
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