Sarah's Journey 2/22 conservative NECK ChineseCrestd CANADA

Sarah, I'm sorry to hear getting pain under control has not been easy. You may wish to talk with the vet as there is still room to move a bit more on meds. If the pain can't be brought under control with the most aggressive use of pain meds, then certainly surgery is a consideration.

=Tramadol looks to be dosed at the max
=methocarbamol has room to move: www.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspx
=Gabpentin also has room to move:http://vasg.org/g_drugs.htm#GABAP     Discuss with your vet about Rxing 3x a day so that the needed level of gaba stays in the system more evenly (gabapentin elimination half life in dogs is 3-4 hours www.ncbi.nlm.nih.gov/pubmed/3730018 )

As an example if Rx'd approx 33mg of gabapentin 3x/day then:
 Divide the 100mg capsule powder into 3 equal parts by dumping into a creased pieced of paper and with a razor blade move the powder into 3 equal piles.  Store the remainder of the powder piles in one of those 7 day pill boxes with a lid for each day.

NOTE: both tramadol and gabapentin are very bitter tasting. Make sure you do not transfer any dust from your finger to the outside of the pill treat.  I mash a piece of banana, form a ball, make an indentation.  Spoon powder dose into well and close up. If necessary drap a piece of thin deli meat around ball for further tastiness!
 
 
Oral Bioavailability in humans
Gabapentin bioavailability is not dose proportional; i.e., as dose is increased, bioavailability decreases. Bioavailability of Gabapentin is approximately 60%, 47%, 34%, 33%, and 27% following 900, 1200, 2400, 3600, and 4800 mg/day given in 3 divided doses, respectively.
www.drugs.com/pro/gabapentin.html

Neck discs ARE very painful and take not only aggressive pain meds measures, but also doing these extra things outlined in this article: www.dodgerslist.com/literature/cervical.htm

This information on surgery will give you good perspective, costs of surgery, etc: www.dodgerslist.com/literature/healingsurgery.htm

There is also a consideration to move to the most powerful of the anti-inflammatories the steroid class. This would take serious discussion with your vet as a switch from non-steroid anti-inflammatories such as Metacam normally requires a 4-7 days safety washout. Any time an anti-inflammatory is on board, GI tract protection should be on board such as Pepcid AC.  A switch if deemed of a an emergency situation would required double protection: Pepcid AC plus Sucralfate.

The FDA and manufacturer pkg insert indicate gastrointestinal problems are side effects of using NSAIDs. The natural defenses of the stomach to shield against stomach acid is hindered when taking NSAIDs. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms. Phrase the question to your vet this particular way:" Is there a medical/health reason my dog may not take Pepcid?" If there is no reason, we follow vets who are proactive in stomach protection by giving doxies 5mg Pepcid (famotidine) 30 minutes before the NSAID.  This directory very good for learning about each of your dog's meds:
www.marvistavet.com/html/pharmacy_center.htm

Journey is doing really well. We increased his meds on march 1st and continued the higher dose until the 4th. On march 5th he began to act like himself again. I started tapering him back to his original dose and he has continued to do really well. I took him to the vet today and he said we can stop medication and see how he does. He also said we can stop crate rest. I have moved him to an x-pen so he has a bit more room to move around. I won't give him the run of the house for at least another week or two just to be sure. Is there anything else I should be doing at this point?

Thank you! I didn't feel good about stopping crate rest as everything I have been reading says 8 weeks. He has still been confined in his X-pen and I am still carrying him in and out to potty. Back in the crate he goes! So far he has been off all meds for 24 hours and is showing no signs of pain

Journey is showing signs of pain again. I have started him on tramadol and methocarbamol. I'm all out of metacam but I can get some tomorrow when my vet opens. How long should I give him pain meds for? Should I go get more metacam? Does he still need metacam at this point? I will be calling the vet in the morning but I thought I would ask here too.

He's holding his head low and trembling. He is back in an actual crate, instead of the x-pen because he would try to stand on his hind legs in the pen. I will call my vet today and see if he can meet me there to get some metacam. Thank you for your help

Thank you for responding so quickly with so much information. Yesterday when I took him outside he was feeling good and started moving around quickly and pulling at the leash to bark at the neighbors dog. I brought him in right away and I could tell he over did it. He seemed good throughout the day but this morning he was in visible pain.

I am so sorry that Journey is having signs of pain. I know how discouraging it is to have something like this happen when things seemed to be going so well. Keep us posted on yur Vet visit.
Keeping you in thought and prayer.

Good to hear that his pain is controlled and a good idea to extend his crate rest to ensure that he is well healed. I know it's a drag but it is the best choice - you are doing a great job managing Journey's IVDD