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Post by jennrobertson02 on Dec 31, 2013 17:20:45 GMT -7
-- Sweet Pea -- 15 pounds- 6 years old -- Dachshund and the vet did not specifically IVDD -- Saw the vet 12/30- has been on crate rest since 10AM on the 30th. She seems worse today than she was yesterday.Tramadol 50mg- give 1/4 2-3 times a day as needed Prednisone 5mg- one tablet 2 times a day for the first 3 days, then give 1 tablet a day for 3 days, then give one tablet every other day for inflammation (I was given 20 pills) -- I tried to carry her outside this morning to go to the bathroom but she started yelping and just stood there. I then took her inside. I am scared to try and take her out again. -- Has not gone to the bathroom all day.-- Ate and drank just fine yesterday, has drank a little today, has not really eaten, I put peanut butter on my finger with her pills and she will eat that-- Pooped just fine yesterday nothing weird but has not gone out at all today. The vet thought she would be fine with rest. She has never had any problems. She has slept with me since day one (6 years ago). I put her in her cage last right, it was very hard but now I just feel like everything is getting worse.Now my vet is closed until 9am on Thursday. I really cant afford to go to an emergency hospital.  |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Dec 31, 2013 18:11:57 GMT -7
Jenn, welcome to Dodgerslist. First things first…she is being undermedicated for pain. Pain is not a one size fits all deal…it can take some back and forth feedback and the vet making adjustment. Pain is not just torture but it also slows the whole healing processes plus you can't take care of her properly, she can pee or poop because it hurts too much. Tramadol is a short acting pain reliever. Have you been giving it promptly 3x a day and there is still pain? Your vet is Rxing at a VERY low dose for a 15 pound dog. And he also has options to add in other medications such as muscle spasms so comment with a neck disc problem. Often neck discs required a third added in called gabapentin. There is no reason she should be in pain, when in an hour with properly prescribed pain meds she can heal in comfort. Do your own homework so you can advocate for the meds she needs to get pain in control and do what you need to do…go to ER if necessary tonight…this is one of those times it really can't wait. Put it on plastic, get mom/dad to help you help Sweet Pea, etc. www.vasg.org/alphabetical_drug_summaries.htm [alpha listing of veterinary drugs…. look up Tramadol] www.marvistavet.com/html/pharmacy_center.html [look up Pepcid AC] Ask in this particular way: is there any health reason my dog may not use Pepcid AC? If no reason protect the GI tract with 5mg Pepcid AC 30 mins before Prednisone and there after every 12 hours. SP does not need another problem of bleeding ulcers on top of what she is dealing with. She also has been given a VERY short course of Prednisone at three days and then a taper is to start. Often it takes 7-30 days at the 5mg 2x a day dose before all the swelling is gone. So do not be distressed if it is too soon to start a taper tomorrw because she obviously is in pain today. So you will also need vet help in extending predisone a bit longer before testing the water on painful swelling with another taper. Let us know what the vet has done to change meds tonight. Set up an email alert so you know when someone has replied.  |
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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 Jan 2, 2014 15:12:39 GMT -7
How is Sweet Pea doing today? Did you have any luck contacting a knowledgeable vet?
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Post by jennrobertson02 on Jan 2, 2014 15:58:22 GMT -7
She is actually doing better. She seems to only have problems in the early morning. I have been setting my alarm though to give her pain medication in the middle of the night. She did eat yesterday finally and drank more water (She didn't eat or drink hardly anything on Tuesday). I have also been able to take her outside to go to the bathroom without her yelping. I haven't taken her to a new vet yet because she seems to be a lot more comfortable. I do have one lined up though if anything changes.  |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 2, 2014 17:53:45 GMT -7
I'm very glad to hear that Sweet Pea is doing better, Jenn.
Just to clarify - when you say that she only has problems in the early morning, does that only happen if you don't give her the pain meds during the night? Are you giving the Tramadol every 8 hours?
You should not be seeing any signs of pain from one dose of the Tramadol to the next dose. Pain should be completely under control. If not, the meds need to be adjusted by a vet. More importantly, a taper of the Prednisone should not be started if there are any signs of pain whatsoever. Pain = swelling = more time on meds. She was given a very short course of Prednisone with a taper starting, I believe, tomorrow.
Please also confirm that Pepcid AC has been started as Paula recommended. It's very important that this protection be added.
Good job on having a more knowledgeable vet lined up if needed.
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Post by jennrobertson02 on Jan 7, 2014 16:23:40 GMT -7
I am giving her
tramadol every 8 hours.
Pepcid AC. I did actually take her back to the vet Friday. She is now taking
Methocarbamol 500MG-1/4 tablet 3 times daily as needed for pain. The vet also told me to continue to give her Prednisone every day.
She had a good day yesterday, wagged her tail for the first time in over a week and all. Then, 6 o'clock hits and it goes down hill. She had the worst neck spasm I have seen, threw up and everything. I have her the methocarbamol and her tramadol and she seemed to calm down. Today it seems like she has had a lot of neck spasms. Is it normal for her to have good days and bad days?
She is still eating and drinking. I take her out to go to the bathroom and she does just fine.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 7, 2014 18:05:49 GMT -7
Is the prednisone 5mg 2x a day or less? Let us know the details…is she taking less than the anti-inflammatory dose… less than 5mg 2x/day?
If she IS taking the anti-inflammatory dose, then get on the phone to let the vet know about the pain. Ask for gabapentin to be added to the Tramadol and the methocarbamol. Because we do not have an accurate updated med list with mgs and frequency, we are kinda in the dark to make comments. For a 15 pound dog your vet has room to move with a higher dose of methocarbamol and maybe even Tramadol. Pain meds with a disc episode are NOT given on an as needed basis. They need to be prompt and on schedule so that no pain shows nearing the next dose.
15 pounds:
Tramadol 50mg- ? mgs of the 50 mg tablet are you actually giving every 8 hours?
Prednisone 5mg- How many mgs of the 5mg Pred tablet are you giving, how many times a day?
Pepcid AC ?mg, ?x/day?
Methocarbamol 500MG-1/4 tablet 3 times daily . Are you giving 3x/day promptly?
If Pred is less than 5mg 2x a day, the she is on a taper and that would explain the pain and the need to get back on the original anti-inflammatory dose. Neck discs can take longer to heal because the head moves when most any other part of the body moves…aggrevates the healing process.
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Post by jennrobertson02 on Jan 8, 2014 9:47:52 GMT -7
I am giving her 1 prednisone 5mg a day. I am giving her pepcid AC once a day. Should I do more? I am also giving her methocarbamol and tramadol 3 times a day (every 8 hours)
I just got off the phone with the vet and he is giving Sweet Pea more Tramadol and Prednisone. Should I be giving her two prednisones a day?
Would looking into a chiropractor or acupuncture help?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 8, 2014 10:11:38 GMT -7
Jenn, good job on getting with the vet and an extension on the meds Sweet Pea still needs to be on! Your vet started out with a very short course of Prednsione. It was a 3-day course at the anti-inflamamtory level: 5mg Pred 2x a day. Then he called for a lowering, a taper moving away from the highter anti-inflammatory dose, moving down to 5mg Pred 1x a day.
Often it takes being at the anti-inflammatory dose of prednisone (5mg 2x/day) for 7-14 days or even for some dogs more like a month before all the swelling is gone. When the vet guesses swelling might be gone there will be a taper. The dose is lowered to less than the anti-flammatory dose your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. To have a clear picture on a taper, pain meds are also stopped or backed off too.Rule of thumb is: pain = swelling = more time on Pred, pain meds and Pepcid AC is needed. If there is no pain on the taper then it goes to completion. Then no meds at all are needed. Disc healing will continue for the remainder of the 8 weeks. Nerves can continue to self heal…think in terms of months. So it is clear it is NOT time to be at a less than anti-inflammatory dose of Pred. Can you give us the specifics on the pred…what does "more" mean. What dose in mgs' and how often did he Rx for Tramadol and for Prednisone? Did he mention how long he was trying this course of pred or when you are to start the taper? Please correct this list to give us the latest information: 15 pounds: Tramadol 50mg- ?mg, 3/day Prednisone 5mg- ?mg, ?x/day?Pepcid AC ?mg, 1/day? Methocarbamol 500MG-1/4 tablet 3 times daily In the early days of an IVDD diagnosis, it is very good to have a shoulder to lean on while getting things right. But for the long term it is vital to educate yourself by reading so you know when to avoid harmful treatments, have the ability to discuss and bring up topics with the vet. YOu and the vet are a team and your actual job is to be the TEAM CAPTAIN. For that position one needs to be well read. I also highly recommend adding this comprehensive "must-have" $3 DVD on IVDD to your arsenal of educational resources. Friends, family and those who will be caring for your dog should also watch this DVD www.dodgerslist.com/literature/litorder.htmMay I point you to the article on "Chiropractics" and why it is not recommended PLUS the one on acupuncture here: www.dodgerslist.com/healingindex.htm Here is one vet's overview and his prices just to get an idea: www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] |
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Post by jennrobertson02 on Jan 8, 2014 11:17:59 GMT -7
I have the same medications. The vet just gave me another prescription. I have 50 tramadol and 50 prednisone. I can now give her two prednisone's a day to help with the swelling.
Tramadol 50mg
Prednisone 5mg
Pepcid AC-10mg-I was giving it once a day
Thank you guys for all of your help. I was really having a hard time.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 8, 2014 11:43:49 GMT -7
Jenn, good work on getting Sweet Pea on an extension of Pred and thanks for the details that we so LOVE! LOL
Did the vet indicate how many days to give the 5mg Pred 2x/day for? Just wondering if he had in mind how long this course of pred would be.
You now know the drill at the time the taper would start, you will need to be on your toes to observe for any hint of pain surfacing and let the vet know asap/pronto. We always hope that 7-14 days will get all the swelling resolved but there are plenty of cases where it does take longer.
15 pounds:
Tramadol 50mg tablet: giving 1/4 tab (12.5mg) 3/day
▲Prednisone 5mg 2x/day as of Jan 8
Pepcid AC 10 mg, 1/day
Methocarbamol 500MG-1/4 tablet 3 x/day
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Post by jennrobertson02 on Jan 8, 2014 12:00:16 GMT -7
He didn't indicate how many days to give the medicine. I didn't actually see the vet this time. I am going to start to give her two Pred's a day though.
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Post by Sherry Layman on Jan 8, 2014 13:14:24 GMT -7
I noticed in one of your posts above you are giving the Pepcid once daily. It should be given twice daily, every 12 hours, for as long as she's on the Prednisone. Even when you are giving the Prednisone once daily or even every other day she should have twice daily Pepcid.
I'm glad your vet increased the Prednisone back to twice daily. You won't want to wean this again until she appears pain free and you can get the Tramadol and Methocarbamol stopped as these mask pain. We WANT her pain masked right now so she is comfortable, pain is detrimental to healing. But the Prednisone is the medication that is actually assisting her body to heal. If she is off the pain meds and is pain free the Prednisone taper can begin. If she still has pain she still has swelling and needs the Prednisone at full dose.
I'm still not sure we've clarified the Tramadol dose she's getting, can you make sure we understand? The first post looks like a 50mg tablet cut in 1/4 with that 1/4 tab being given every 8 hours. If that is the case she's getting roughly 12.5mg every 8 hours. Is that correct?
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Post by jennrobertson02 on Jan 8, 2014 13:25:44 GMT -7
I will start giving her pepcid every 12 hours. She is given 1/4 tab of tramadol 50mg every 8 hours. I have had to give it before the 8 hour mark a few times though for pain.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 8, 2014 14:34:09 GMT -7
If now that she is back on the original Pred dose (5mgs 2x aday) and there is still pain showing near the next doses of pain meds, let the vet know this information. 12.5 mgs is a VERY, light dose of Tramadol. Your vet has room to move up in dose so that there is NO pain showing at all dose to dose.
I agree with Sherry and the manufacturer too… Pepcid is effective for about 12 hours. Give 5mg Pepcid AC 30 mins before Pred and thereafter Pepcid AC every 12 hours. Give Pred with a meal.
15 pounds:
Tramadol 50mg tablet: giving 1/4 tab (12.5mg) 3/day
▲Prednisone 5mg 2x/day as of Jan 8
Pepcid AC 10 mg, 1/day --->better is to give 5mg 2x a day<--
Methocarbamol 500MG-1/4 tablet 3 x/day
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