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Post by Lauren & Lacie on Nov 25, 2013 19:30:08 GMT -7
Ok I won't take her out. The er tech /dr said to do it and more ...like treat her normal..envourage her to walk by putting food further away....bad advice
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Post by Pauliana on Nov 25, 2013 21:03:12 GMT -7
Good for you Lauren realizing you were getting bad advice from the Vet.. I am glad you are going to continue strict crate rest.. Here is a great article on how to find an IVDD experienced Vet. www.dodgerslist.com/literature/VetchkList.htmThanks for keeping us posted on Lacie..
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Post by Lauren & Lacie on Nov 26, 2013 5:22:50 GMT -7
The nuerologist said little movement is best but yea the man at ER said opposite. But I keep her on bed all times except when I clean her in bathroom sink after she's peed or #2 and put her back in. She changes positions on her own and goes reaching for water. I amwwaiting for nuerologist to call so I can adjust tramadol or gabapentin higher
The nuerologist at the wvrc is dr. Bensfield and she is board certified. She isn't the one who said to try and get her to walk but a tech at the animal ER did. I think his title is above a tech since he teaches tech's. But since I finished laser treatments I won't be going there just going to wvrc. I left another message for nuerology dept to get back to me..I think gabapentin or tramadol should be imcreased or add that one u told me about yesterday. Because she seems better now that she has gaba back. .but still yelped before I touched her ..like aniticipation...but last week that had stopped while on the compounded pill gaba/tramadol 15mg. And when I cleaned her just now after going potty..I hold her stomach area while washing her in bathroom sink so I can wash hind legs etc but she did a tiny yelp as I tried switching hands like her tummy hurt ..maybe I pulled skin or maybe that affects her disc??? I am going to ask the nuerologist but its hard to believe or trust her when u tell me certain things and she says not to do certain things like for example that the pepcid was needed but I think it is. So I do 5 mg a day but would if 10mg is better? How do I know if that's why her tummy hurt? But her stool is not bloody. Its not like the stool from before this whole incident but its better than when it first started it was more runny...but that's cuz sje wasn't eating hard food either. Now its more solid but its darker brown and bigger and softer simce I've been giving her soft food to eat pills and hard food in afternoom
And when this began she had a fever do u think its because of stress and pain? She doesn't anymore. Also have u heard of k9 immunity med? Do u think that would help her nerves/disc? Or is rest the only thing that helps?
What kind of can food should I get? The ER gave her cans if royal canin recovery but I don't think she needs that..can it be their regular brand? I give nutro natural choice adult
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Nov 26, 2013 11:26:44 GMT -7
8 weeks of strict crate rest and good pain control is what will allow her to heal. Not special supplements and certainly not walking around! Thank goodness you are smarter than that ER tech - (who should be fired, by the way, for handing out such dangerous advice!) Supplements don't cause a disc to heal, only time will allow good scar tissue to form. Be very careful about cleaning her in a bath - we don't recommend bathing as it can cause movements that can cause pain. Unscented baby wipes work well to clean up after urine and poop, so does cooled off green tea. I do realize that sometimes that just doesn't cut it if the dog is really furry like my Stevie is - I had to use alot of wet wipes to get her clean. Lacie can eat her regular food, moistened with water or chicken broth. A bit of canned food mixed in is nice, to tempt her appetite and keep her hydrated, and it doesn't really matter what kind, as long as adding it doesn't upset her tummy and cause diarrhea (that is all you two need!). You are doing a great job caring for Lacie and being a GREAT advocate for her with the Vets that you are seeing. Keep up the good work
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Post by Lauren & Lacie on Nov 26, 2013 12:02:51 GMT -7
I think I have to rinse her when she urines herself cuz she is a long hair chi and when I didn't use sink she got urine burn a few weeks ago. So using sink is keeping her clean and good skin. A few weeks ago she would itch her right side a lot for no reason and got a scab but that's healing up cuz I keep it dry and she quit itching herself with back legs. She sits sternal now more now that she's back on the gabapentin and gets her own water by using front legs and scooting forward. I calledthe pet apocethary ..they make the pills..and asked If i could get the 100mg gabapentin and divide powder up but he said he thought it would be risky to do that cuz it might not be acurate and that's deadly. Is that true? But I found out I can get a 3 momth supply for good deal so ill stick with that next time. I just spoke to nuerology and they said dr bensfield wants to keep her on the pain pills she's on and not add another until she sees lacie so I can't add that pill u reccomended. She also said not good idea to break up powder of gaba. I told her about how I just put her back on gabap so I'm gona see how she does this week and come next week instead. Also I reasked about pepcid and its still 5mg a day. Seems low to me too. She didn't kmow why she cries wen I touch tummy. Also said I don't need to express her bladder since shes going well. And the stool change is normal too. If strict crate rest means she can't move then is she hurting herself by leaning and getting water? I can't watch her while I sleep etc so I feel like I'm doing the best I can. And my husband appreciates what I'm doing but complains about money spent on vet or pills. I'm wondering if there are any orgs who can help with that.
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Nov 26, 2013 12:12:13 GMT -7
Hi Lauren, your post got cut off. what is the dose of gabapentin that Lacie should be getting??
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Post by Lauren & Lacie on Nov 26, 2013 14:24:18 GMT -7
See above that's the post I edited...my most recent
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Nov 26, 2013 15:12:11 GMT -7
Lauren so we do have it correct all in one easy to follow list, let us know if this is the current one with doses and frequency: 6 lbs tramadol (50mg)- 1/4 every 6 hrs 1/2 tablet Clindamycin (75mg) every 12 hrs Prednisone (5mg)- 3/4 tablet in am and 1/2 pm pepcid ac (10mg)- 1/2 tablet (5mg) every 24 hrs Gabapentin liquid- 1ml 2x a day ( liquid gaba says '15mg/ml' ) If you need to cut off some fur to make clean ups easier, then take out your scissors. Anything you can do to avoid her being out of the crate, making clean ups easier it critical to the healing disc. Baths, wet slippery dogs is just too risky. Instead clean her up in the crate or just outside of it with baby wipes or a damp washcloth. The green cooled tea can help to neutralize acids in urine to prevent scalding and urine burns. Attach her water and food bowls at an easy head height inside the recovery suite with plastic food containers, a hole punch and string or tie wraps.
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Post by Lauren & Lacie on Nov 26, 2013 15:46:00 GMT -7
Yes that's right except overnight I don't give tramadol....i give it at 9pm then 6am. She is already shaved on her backside and clipped for easier washes. She is not in a bath or tub...I hold her by stomach with my hand while I rinse her backside in bathroom sink. SShe is in big brown bed with a towel on it and a puppy pad on that and enclosed by a black fence pen. The food I give her is set next to her head so she can eat it where she sits..the water is in front of bed which she leans over to drink...is that ok too? ....I don't know how many mg is in ml..I will call soon to ask.
The liquid gaba says '15mg/ml' so I'm guessing 15mg is one ml? But that sounds like the dose has been doubled from last time because before the combo pill gaba and tramadol was 15mg. Now gaba is 15 alone? I am going to call wvrc since pet apocethary is closed
Yes its 15 mg for the ml.........and when she was taking compounded pill of gaba/tram it was 15mg for each . And the tramadol now is 1/4 every 6 hrs of 50mg. But I try to do every 6 hrs..lately just doing 6am 12pm 6pm then 12am ...or if I go 8 or 9 hrs stretch sometimes ill do 12 pm then 9pm then 6am...so not more than 9 hr wait..usually 6 hrs
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Post by Lauren & Lacie on Nov 27, 2013 10:18:06 GMT -7
I put the water bowl higher but she still stands to drink it and sits back down..is that ok? I think she's getting better too since before she could not stand or move barely. But as she is supposed to..she sleeps/rests all day in bed. Can I attach photos?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Nov 27, 2013 10:41:54 GMT -7
Lauren, the idea with the water bowl at head height, could be head height when sitting or when standing is to eliminate movement of the neck..not having to bend down or bend the neck upwards. It is ok for her to stand up if she wants. Sleeping and resting is very good for healing. Here are the directions to share photos. Just upload to our gallery and then copy the photo's address (URL) into one of your posts. How to: dodgerslist.boards.net/thread/260/upload-photo-dog
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Post by Lauren & Lacie on Nov 27, 2013 11:17:26 GMT -7
Do u think there's a point in going to see nuerologist next week? If lacie needs 8 weeks crate rest what is the point in having her looked at. They don't know if its ivdd although realistically it probably is. Do most dogs heal in 8 weeks? As long as she's on gabapentin, tramadol, prednisone isn't that allI can do? For the vet to check her leg function is pointless to me because of course she can't walk yet. When dogs heal on 8 weeks crate rest, are they up walking etc? What exactly should I expect to see towards 8weeks?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Nov 27, 2013 11:24:10 GMT -7
If all is going in a good direction of healing, you do not feel the need for a 2nd opinion to get meds right, there is no diminishment of neuro functions or pain, then I would continue with conservative. The less moving her about the better for her healing disc. Do most dogs heal in 8 weeks? Well, we have to know which of the healing phases you refer to. I think your mind will be at much more ease to have an understanding of what to expect... I know that is how my mind works.... Dodgerlist has done a marvelous job of answering your questions plus maybe some you have not yet asked. Check out this page...let us know if there is anything that was not adddressed and let's talk about that. Here is the page: www.dodgerslist.com/healingindex.htm
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Post by Lauren & Lacie on Nov 27, 2013 12:16:52 GMT -7
Ok ill keep that in mind. Today she has drank water out of bowl and stands to do so. Also I made a sandwich and for the first time in weeks she was about to try to get out of her bed to follow me for sandwich and I told her no. So that really surprised me . I'm willing to give her all the time to heal but that makes me think she won't need a whole year. When she stands for water or does things like trying to walk does that reverse any healing? Or only if it tears tissue?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Nov 27, 2013 14:49:42 GMT -7
The phases of healing are four in number. Each of them takes a different amount of time to achieve and by different methods. Pain relief phase should take one hour with the right meds on board. The other three phases of healing have differing times and ways of healing. Maybe start with this overview to help your mind see the whole picture: www.dodgerslist.com/literature/healingpage.htmWalking around, too much movement inside the recovery suite all make the spine move, the vertebrae in the spine move and pressure discs. Pressure to a weak disc would make it tear. So a few footsteps at potty time is necessary, a bit of turning around to switch sides or standing to eat inside the recovery suite should be ok.
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Post by Lauren & Lacie on Nov 30, 2013 18:14:58 GMT -7
Can lacie have a little bit of carrot or crumb of toast? I used to give her little things like that but I think I read it can interact with her meds is that true? And an update. ..she still stands to drink and today tried standing to eat. Yesterday I went on errand for 2 hrs and came back to her water bowl spilled a little and her sitting next to it out of bed so I'm guessing she tried to walk or fell out of bed getting water. There were and still are no signs of pain from that or changes thank God. Also I refilled the tramadol but another dr filled it since regular dr is not in til mon or tues. New presciption said give 1/4 pill of tramadol every 12 hrs. Before I was told by nuero dept to do every 6, 8, or 12 hrs depending on how sje feels and I was doing 6 hrs. So until I get answer monday from vet I'm gona stretch it to 8 hrs. Is that overdosing if its every 6? The people working on weekend said that it is.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Nov 30, 2013 18:58:25 GMT -7
I personally don't know what the dosage of Tramadol would be for a 6-lb. dog. I would double check with the neuro dept as soon as you can about giving it every 6 hours because it did seem as though Lacie was doing well with it every 6 hours and that is what they had originally told you to do. If you decide to stretch it to every 8 hours, keep a eye out for signs of pain and immediately notify them that you're returning her to every 6 hours.
It sounds as though you have Lacie's bed inside the crate and there is still room for her to get out of bed and go to her water. The crate should only be large enough for her to stand up, turn around and lie down with her legs extended. If it's too large, that would give her too much room to move around. Do you have the water hung on the side of the crate as shown in the photo Paula and I shared with you so it doesn't spill and she doesn't need to bend her head down to drink? If the crate is too large, you could move her bed up to the front and roll up some blankets or towels high enough to block off the back of the crate. It's OK if she stands to eat or drink.
Let us know what the neuro dept says about her dosage of Tramadol after you speak to them.
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Post by Lauren & Lacie on Dec 3, 2013 12:17:37 GMT -7
What I'm doing was fine ..every 8 hrs ..I can do 6 but 8 is working out fine. Also they are making me come in for another recheck in order to 'still prescribe' her pills which I told them I prefer not to and want to keep doing what I'm doing but she didn't budge. So now I have to spend another $55 plus lots of gas instead of saving money for pills. (We are broke)
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Dec 3, 2013 15:07:35 GMT -7
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Post by Lauren & Lacie on Dec 3, 2013 18:12:42 GMT -7
Yes but ill call again ..but the vet I go to charges for rechecks...but moved so I gota find new vet. But this is the wvrc so they're not a vet and they charge all the time and are expensive. But I don't know where else to go that has a board certified nuerologist. The usual vet I used to go to sometimes wouldn't charge for recheck. I get the pills at walmart now except gabapentin... but when they see her next time they might change or add a pain pill or steriod so I'm worried they'll want to make me get the pills they sell which are expensive. Hope not. How can I get a free recheck? Just asking won't work I know it.
Lauren
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Post by Pauliana on Dec 3, 2013 20:48:36 GMT -7
Hi Lauren, Just mention to them that most vets don't charge for rechecks and see if that helps.. Also tell them to write a prescription that you can take to your pharmacy. Here's an article that tells how to find an IVDD Vet and also has a search feature to find one in your area.. www.dodgerslist.com/literature/VetchkList.htmFingers crossed for you and Lacie..
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Dec 4, 2013 9:34:17 GMT -7
For conservative treatment, a specialist is not required. A general DVM vet who knows IVDD can just as well supervise, prescribe meds, etc. As long as you have your IVDD education under your belt, you can assess if a vet knows IVDD, you know to recognize red flag advise and ignore (using NSAIDs with steroids, PT during crate rest, allowing pain) Pauli gave you a good link to help you make a plan for finding a new vet.
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Post by Lauren & Lacie on Dec 9, 2013 5:24:07 GMT -7
I'm refilling gabapentin today. .is pill or liquid better? Is liquid easier on tummy? I had liquid for 2 weeks. Pill would be easier to give though
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Dec 9, 2013 7:55:14 GMT -7
The problem with a capsule full of powder is being able to divide it into the required small dose Lacie needs. This is why liquid is better for Lacie. Gabapentin in any form is not typically hard on the stomach.
Is she still on these same meds, no changes to Prednisone? Have you discussed when the vet would want to test the waters to see if all the swelling is now gone by doing a prednisone taper? 6 lbs tramadol (50mg)- 1/4 every 6 hrs 1/2 tablet Clindamycin (75mg) every 12 hrs Prednisone (5mg)- 3/4 tablet in am and 1/2 pm pepcid ac (10mg)- 1/2 tablet (5mg) every 24 hrs Gabapentin liquid- 1ml 2x a day ( liquid gaba says '15mg/ml' )
Do you have a different (new) vet for today? How is her pain, no observations arising nearing next dose or after having moved? Is she still able to move herself up into a standing position so drink water, etc?
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Post by Lauren & Lacie on Dec 9, 2013 8:07:18 GMT -7
well the place I get the pills compounds that with tramadol so I might go back to doing that instead....but lately with the liquid and giving tramadol every 8 hours has been working out well because she does not Yelp or seem in any pain....but I think it would be easier to have the pills compounded then I wouldn't have to give her pills so frequently. But I worry if I make a change she might go back to being in pain.
Now she's just on prednisone, gabapentin and tramadol. And the 5mg pepcid. Yes I think tomorrow ill go to nuerologist one more time to see what she wants to do and to get plan for future etc. But she is doing well..standing to drink water and eats, drinks,and goes bathroom. And like I said doesn't yelp ever. And whimpers for attention sometimes. So once 8 weeks is over, what next? That's when I can start letting her walk?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Dec 9, 2013 9:10:33 GMT -7
When meds are combined into one formulaiton, you do not have the flexibility to adjust just one med. So I'm in favor of each med being separate, not combined into one liquid.
I would discuss what the vet's idea is of when to test the waters so see if all the swelling is now gone. Tapering the predisone dose AND backing off pain meds or stopping pain meds is the way to test the waters.
The rule of thumb is: any hint of pain arising = swelling = more time on Pred, pain meds and Pepcid AC is needed.
Before graduation day, dogs need to have passed the test of off all meds AND no pain. If there is still pain and they are still on crate rest when graduation day should happen, then graduation day needs to be moved to a later date. It is just not safe to have a dog on meds without crate rest.
So let us know what you you discussed with the vet and what his plan is.
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Post by Lauren & Lacie on Dec 9, 2013 12:24:49 GMT -7
Tramadol is $4 from walmart so I'm gona keep that seperate and have gabapentin alone in liquid form. Also I called to see how much gaba/tram compounded was and it costs more. So ill go to nuerologist tomorrow and get those answers and then prob switch to a vet. But she has seemed pain less and improving. But 8 weeks isn't until jan 6. Because I didn't put her on meds etc til at least nov 6.
Should I get 1 month or 2 months more of pain meds then?
Well now I can't get gaba because the vet isn't there and they can't fill it cuz she's gone so I gota wait til tomorow which means she won't get it til wed but most likely thurs so I hope she doesn't start feeling pain when the gaba runs out. I'm trying to see if the other places that saw her when it all began will fill it but fornow she will be out of gp til thurs. But if she's pain free maybe she will remain pain free and we can taper the gp. But I doubt it since it hasn't been 8 weeks yet. But in a way I guess I'm starting the experiment now
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Dec 9, 2013 18:13:29 GMT -7
Lauren, I corrected the start date of disc healing to Nov 6. So you are correct Lacie's disc should have good secure scar tissue by graduation day of Jan 1. The big IF on that is if she is also off of all meds before Jan 1. It is a dangerous idea to have a dog on meds that mask pain, no test(taper) to find out if all the swelling is gone or not. It is usual to try a taper to see the status us swelling and dogs are off meds at least a week or even more weeks before graduation day.
I would work with your vet and ask for a test, a taper off of pred and pain meds, so it can be determined if Lacie even needs any meds at all. Pred is one med you should not use unless you are under the supervision of a vet who monitors and helps with the taper. Until Pred has been tapered and the pain meds stopped as well, you really don't know if there is still pain and swelling.
8 weeks is for allowing the disc to heal. Meds do not heal a disc.
Meds are for allowing a pain free time (tramadol, gabapentin) while prednisone works to get all the swelling down. Often Prednisone will get the swelling down in 1-2 weeks. Some dogs though may take more like a month…you just can not tell how long to use meds until you have tried a taper. The taper is the test.
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Post by Lauren & Lacie on Dec 11, 2013 12:49:44 GMT -7
Yesterday I was supposed to go to her appointment but I had car trouble so I did not make it now I won't be able to go until Saturday or maybe Tuesday. but I call them to see if she should stay on the medicine or what to do in the meantime and since she has not been seen in at least 3 weeks they don't want to tell me what to do or to stop medicines so they told me to stay on tramadol and prednisone until next week. like I said she has already been out of gabapentin. so far she has been ok and not in pain or yelping she only yelped a little tiny one last night but I don't know why but all day today she has been fine. before I go see the neurologist they said they want me to get blood work donebut I'm wondering if I should just not get blood work and not see a vet and just let her finish the 8 weeks of crate rest and then go see a regular vet and that's it...but they will probably charge for a exam and blood work so either way I have to pay. but I know you said it's time to taper so how do I taper the prednisone and tramadol? otherwise I'm thinking maybe I should just go to a new vet near my house since we moved and I'm looking for a new vet and he can just see her and check her pain and prescribe pain med if it is still needed. what do you think I should do should I see the neurologist or should I just see a regular vet? or see nobody and just let her finish the crate rest and heal at home like she has been?
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Post by Lauren & Lacie on Dec 11, 2013 13:24:44 GMT -7
And if the plan is to not be on meds why do blood tests (Chemistry complete blood count and manual differential) when I dont want to use meds anymore? Particularity prednisone since u said its for swelling and that's prob all gone by now.
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