PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,579
|
Post by PaulaM on Jun 2, 2013 14:55:25 GMT -7
June 1 graduation date will be here soon! :-) 1) & 2) After crate rest then what? Everybody want to know the answer to that one. So, of course, Dodgerslist has a sample schedule of re-introduction back to physical activity, how to make your home back friendly, etc. on the main Dodgerslist website… look to the far column on the right: www.dodgerslist.com/literature.htm#afterrest3) You might consider pushing the length of your bed against the wall so that two sides of the bed are blocked from exits and your body would be the 3rd side of the blockade. Boner could wear a harness where you secure a leash to the headboard to keep him from any midnight escapes or if he hears a sound. Another idea is to put the crate on top of your bed for Boner to sleep in with you at nights. 4) As far as I could tell from your writings you never mentioned any neuro diminishment (wobbly walk, knuckesl paw) just pain with this disc episode. So since there is no more pain nor any neuro diminishment that nerves would benefit from laser light therapy, I would say he does not need laser light therapy. As for vaccinations, that is a subject you will need to bone up on to make sure you know the 2011 guidelines. Recovering from IVDD, consider delaying any vaccinations for while. Vaccinations do take a severe toll on the immune system plus there is starting to be some discussion about further dangers of vaccinations. IF you're not up to speed on current recommendations on vaccinations, here is some info: www.itsfortheanimals.com/DODDS-CHG-VACC-PROTOCOLS.HTMhealthypets.mercola.com/sites/healthypets/archive/2011/06/21/expert-proof-most-pets-are-vaccinated-way-too-often.aspxVerify by your own research what the rabies requirements actually are for your area rather than asking your vet. Many states have gone to requiring Rabies every 3 years although not all. Some states allow an exception for Rabies due to illness and IVDD qualifies for that illness. In fact the vaccination bottle states for use on healthy animals only. The other vaccinations are no longer or even recommended yearly anymore. You'll need to get up to speed yourself so you can advocate for your dog. Discuss the real risk of getting any of those diseases where you live and the lifestyle of your dog with the vet rather than just going ahead and getting the vaccination. 5) Spend your money wisely when it comes to supplements… much of it is buyer beware and be educated. The best way for the body to use minerals and vitamins is from a good quality food. You can begin both your supplement and Nutrition/diet readings also on the Dodgerslist main web site…. www.dodgerslist.com/literature.htm#afterrestCal, you have given Boner one of the best gifts..your commitment to sticking strictly with crate rest for all 8 weeks. You are doing a wonderful job of caring for Boner!!! On June 1 Boner's disc will be well healed and he can enjoy a gradual introduction back to physical activities and being your sidekick again. Please do continue to let us know how things are going. We have lots of people reading the Forum and Boner is good inspiration to those just beginning the IVDD journey. |
|
|
|
Post by Cal & Boner on Jun 5, 2013 11:57:35 GMT -7
Thank you Paula for the info. I was unaware that vaccinations are really not needed yearly. He is due for his yearly Parvovirus vaccine and Distemper-Hepatitis-Parainfluenza Vaccine. I am taking him in tomorrow for his yearly exam and a toenail trim and will definitely be discussing the vaccines with my vet- but I was wondering if anyone else had any thoughts on the vaccines- such as how long to wait after a disc episode to get them if I decide to- or anyone's thoughts in general on having vaccines done yearly vs. every 3 years...
Thanks again.
|
|
|
|
Post by Linda Stowe on Jun 5, 2013 14:32:10 GMT -7
Cal, all the vets that I have dealt with for several years, now give those vaccines every 3 years and some of them recommend you not give them all in one shot. I don't have any dachshunds now unfortunately, but didn't give annual shots for many years. Do your research on this, many articles on the web. Rabies may be different, as Paula says, so do find out exactly what your city or state requires. speakingforspot.com/blog/2013/03/17/veterinarians-and-vaccines-a-slow-learning-curve/ |
|
|
|
Post by Cal & Boner on Mar 4, 2014 3:38:18 GMT -7
Hi everyone,
My dog, Boner, had a disc problem almost one year ago for the first time and I believe he may be having a flare up again. My old thread from then is in the dog updates section on page 10 and I wasn't sure if I should post this there or here...the help I received from this site was so critical to me then and I am hoping for some help again now. So thank you all so much in advance.
I first noticed him shivering earlier today and was a bit concerned but it seemed to go away pretty quickly and he was acting normal again....until tonight. I can tell he is acting strange and the shivering is coming and going. Of course my first reaction is to think this is a disc flare-up. But, last year when it happened it was so obvious that he was in pain...maybe I am just noticingthe signs sooner this time? I will be taking him to the vet in a couple of hours when they open. I have a list of all of the medications that finally got things under control the last time- is sticking with the same meds that I used during his first disc episode the best way to go if this is infact his disc flaring up? (and obviously the 8 weeks of crate rest like last time)
Last time, as you can read in the original thread, the vet mistakenly gave him a steiroid injection along with previcox. Thanks to this site, I have learned my lesson about that whole ordeal and will never just give him meds blindly again. Eventually, Rimadyl ended up being the med that he was put on once the previcox/steiroid combination was out of his system. So, when I go in today, should I automatically say no to a steiroid injection and just have them go ahead and put him directly on Rimadyl along with the other meds he was on with it?
Thank you for any help.
|
|
Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
|
Post by Marjorie on Mar 4, 2014 5:45:04 GMT -7
I'm sorry to hear that Boner may be having another disc episode. You need to crate him immediately until you get him to the vet, if you haven't done that already, to protect his spine. If the shivering is due to being cold, it should stop after he's warmed up. Otherwise, it's a sign of pain. The damaged disc may not be pressing on Boner's spine as hard as it was last time so the pain may be less.
If his symptoms remain mild with other pain and/or mild neuro deficits such as knuckling, Rimadyl can be prescribed. If his symptoms worsen by the time you get to the vet, the vet may want to put him on a steroid. Yes, you're correct that there should not be a steroid injection if he's to be put on Rimadyl. Or he can be given a steroid injection and then given a prescription for oral steroids. NSAIDs and steroids should not be given without a 4-7 day wash-out period. You should have blood work done before starting a NSAID or steroid to check Boner's organ health. Ask the vet if there's any medical reason why Boner shouldn't take Pepcid AC and if he doesn't have a reason, such a heart or liver problems, etc., then do get it on board to protect against the anti-inflammatory side effects. Plus, of course, pain medication.
Please let us know what the vet says after the exam. Prayers for Boner.
|
|
|
|
Post by Jean & Mimi on Mar 4, 2014 8:18:49 GMT -7
So sorry he seems to be having another disk episode, but you are so on top of it! Let us know how things go at the vet, Boner is really lucky to have you.
|
|
|
|
Post by Cal & Boner on Mar 4, 2014 10:07:38 GMT -7
Hi again, I took Boner in to the vet and when he pressed along his back, he showed no signs of pain. However, when he pressed along his abdomen he tightened up and it seemed painful. The vet said his back does not seem to be hurting and it may just be a little stomach discomfort. He has been eating normally and his bowels were ok this morning- so they told me to just watch him carefully today and bring him back in if he continues to show any pain symptoms. At that time, they would probably do bloodwork/x-rays. So, I am hoping and praying that he is correct. I live in fear of seeing him have the pain he had a year ago so I am trying to not be to overly paranoid. Thanks for the quick replies Marjorie and Jean/Mimi. I can't even begin to express how much I appreciate this site and all of the help I have been given. I subscribed to the newsletter as well and love it!  I will let you know any updates. Thanks so much again. |
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,579
|
Post by PaulaM on Mar 4, 2014 10:37:06 GMT -7
Cal when a disc episode happens often there are more than one of these signs of pain: shivering, yelping, reluctance to move much, not their perky selves, tail hangs low, arched back, tight tense tummy of referred back pain, head held high or low. We really appreciate your supporting us with a subscription to our newsletter www.dodgerslist.com/newsletter.htm Subscriptions are how we pay for all of our educational activities.. our free literature program, hosing our main website, this ad free Forum, etc. Thank you for your subscription!! The April issue will be out soon, another issue of great reading which every IVDD pet parent should have. |
|
|
|
Post by Cal & Boner on Mar 4, 2014 17:56:28 GMT -7
Hi all, Boner's shivering worsened today after I went to the vet so I went ahead and went back in and picked up some meds for him: Rimadyl, Robaxin, Tramadol, and Famotidine. Last year when this happened he was given Sucralfate as well because he had some stomach problems from the vet mistakenly giving him the steiroid injection/NSAID combo. But this time he said it wasn't necessary because he is currently having no stomach problems as he has not started anything yet. He said the Famotidine should be sufficient to prevent stomach issues with the Rimadyl. Is this correct? I have my old schedule of meds and am trying to recall how I went about it. If I start him on the Rimadyl tonight, I have to give him the Famotidine 30 minutes prior-is that right? This is my planned schedule starting tonight: 8:00 PM Tramadol -50 mg -1/2 tablet 8:30 PM Robaxin - 500mg - 1/4 tablet 4:00 AM Tramadol 8:30 AM Robaxin 12:00 PM Tramadol ***I have decided to hold off on giving the Rimadyl and Famotidine until tomorrow after I get some responses- As I mentioned above, the vet did not prescribe the sucralfate this time and I wanted to get your opinions on whether or not I should wait to get a prescription for that as well before starting the Rimadyl - or if the Famotidine is enough protection. ***About the Tramadol and Robaxin , do I need to give those a certain time before or after the other two meds? I seem to remember needing to stagger them...? Last time, I gave the Tramadol 30 minutes before the Famotidine. And I gave the Robaxin at the same time as the Famotidine...any feedback on this timing... And, of course, I need to start him on the 8 weeks of crate rest again, right? The vet suggested 4 weeks this time but I am assuming 8 weeks is the way to go correct? Thank you all so much from both me and Boner for any feedback Oh, one more thing, I asked the vet if bloodwork was needed again prior to starting these meds since they are the same ones he used last time (back in april 2013 he had bloodwork done prior to starting). He said no, and especially since Boner was only on the Rimadyl for one week last time and, hopefully, one week this time. Any thoughts? Since I have decided to wait on using the Rimadyl until tomorrow, I could go in and get bloodwork first if necessary. Thank you so much |
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Mar 5, 2014 7:04:12 GMT -7
I'm glad you got all of the meds on board, Cal. Yes, 8 weeks of strict crate 24/7 is necessary to heal the disc. Did you start the crate rest on 3/4? Carried in and out to do potty with as few steps as possible to do his business. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the back from moving and putting pressure on the bad disc. www.dodgerslist.com/literature/CrateRRP.htmSafe vet practice is to do blood work, if blood work hadn't been done recently, before giving a NSAID to be sure organs are healthy and there is nothing going on healthwise where a NSAID shouldn't be given. However, it's important to start giving the Rimadyl ASAP to start getting the swelling down. Swelling is pressing on the nerves and so far there has been no nerve damage but that swelling needs to be brought down. The swelling is causing the pain. Yes, 5 mgs of Famotidine should be given 30 minutes before the Rimadyl and then every 12 hours thereafter for as long as Boner is on the Rimadyl. Famotidine is usually enough to protect from the side effects of the anti-inflammatory. Sucralfate was given last time due to the mix of a NSAID with a steroid. Keep your eye out for any loose stool or loss of appetite and if you do see anything like that, Sucralfate can be added. You can give the meds at the same time with the Famotidine 30 mins before. Have the meds brought Boner's pain completely under control now? There should be no signs of pain from one dose of meds to the next. Please give us the exact dosages in mgs of each med and frequency given. Rimadyl - 25 mg ??x/day Tramadol - 25 mg 3x/day Robaxin - 125 mg 2x/day Famatodine - 5 mg 2x/day Good job on being a strong advocate for Boner, Cal. He's in good hands! |
|
|
|
Post by Cal & Boner on Mar 5, 2014 7:36:39 GMT -7
It is 8:30 my time right now- I have an app at 12:00 noon for the bloodwork- is that too long to wait before starting the Rimadyl?
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,579
|
Post by PaulaM on Mar 5, 2014 8:55:58 GMT -7
To expedite things, can you call and see if you may bring Boner in for a blood draw now, that might be done by the vet tech and not require an appt with the vet at 12:00.
Do fill us in on the med details mgs and ?x/day for each
Rimadyl - 25 mg ??x/day
Tramadol - 25 mg 3x/day
Robaxin - 125 mg 2x/day
Famatodine - 5 mg 2x/day
Is the pain being controlled right now with Robaxin and Tramadol alone?
|
|
|
|
Post by Erin & Sarge on Mar 5, 2014 9:18:42 GMT -7
Cal,
i am having the same anxiety about my Sarge, we are in week 6 right now and my husband and I recently talked about the "whats next" after the 8 weeks so I will be excited to see a response to some of your questions.
I will tell you that we started Sarge on Vetri Disc as a supplement that our vet said would help with his spine health.
Erin
|
|
|
|
Post by Cal & Boner on Mar 5, 2014 13:02:37 GMT -7
Hey everyone,
I took Boner to the vet and had bloodwork done. It came back good, so he had his first dose of Rimadyl today. I also went ahead and had his first laser treatment done today like I did last time. He will go back for two more laser treatments tomorrow and then Friday.
Here is the list of meds. Please let me know if this schedule is OK. The vet said we would add in sucralfate if I notice any bloody stool like last time. Should I give the Rimadyl with a small meal? Are there any other symptoms to look out for with Rimadyl besides bloody stool and loss of appetite?
4:00 AM- Tramadol 50 mg- 1/2 tablet
8:30 AM- Robaxin 500 mg- 1/4 tablet
12:00 PM- Tramadol
12:30 PM- Famotidine 10mg- 1/2 tablet
1:00 PM- Rimadyl 25mg- 1 tablet
8:00 PM- Tramadol
8:30 PM- Robaxin
12:30 AM- Famotidine
Boner's pain is NOT under control yet. I just started the tramadol and robaxin last night- and then the Rimadyl today. Last time, this combination DID get his pain under control. The vet suggested that I give the Rimadyl 1-2 days to kick in before adding in another pain med. But, obviously, I do not want him in pain!
Last year, I purchased Gabapentin 35 mg chews but never ended up using them because I got the pain under control before they arrived in the mail. They are all sealed up individually and have not been exposed to any high temps- but the exp. date is stamped as 10/13/2013.
I asked the vet if it would still be OK to use these being that they are about 5 months past the stamped exp. date. He said they should be fine......any opinions on this? I had to have them compounded and mailed to me from Wedgewood Pharmacy in NJ- so if I have to get new ones, I will have to go through that process again, and have them delivered as quickly as possible- which would still mean a probable two-day wait.
Do you think they are still OK to use and, if so, should I go ahead and start them tonight every 12 hours? Do they have to be separated from other meds?
Also, I was wondering, I know any disc episode is not good. But, it has been 11 months since Boner got his IVDD diagnosis. Is that a good sign in any way that he went that long without a flare up- or is that just wishful thinking on my part? Flareups are inevitable, correct? I have "wiener-proofed" the house since last year and he has not been able to jump on or off anything, and I don't ever let him run really fast like he used to- I have been very diligent about this, which makes it even more disappointing that he is having a flarup again.
As always, thank you all so much for all of your support.
*HELP! this is an update since the above - I really think I need to add the gabapentin- his pain seems worse even on the tramadol and robaxin. Do you think it is usable (see above) and if so, is there anything to watch out for with this med? I called Wedgewood pharmacy and they said not to use it after the exp. date, which I expected...but I asked when the earliest I would be able to get a new order delivered to me and it would be Friday...so I am at a loss as to what to do about his pain now. I'm waiting for a call from my vet also. Please any suggestions...I am panicking!
*Another update- now Boner is sleeping and seems more relaxed- not sure if it is a sedated kind of sleep or that he is actually comfortable and feeling better...he wakes up when I open the cage but then lays his head right back down...his stomach is making a lot of gurgling noises as well... So now I am even more confused. Could the Rimadyl have worked on the inflammation this quickly? He had his first dose about 4 hours ago. If the pain does come back, and I can't get the gabapentin until Friday, do I have any other options?
*Vet just called me back and I told him Boner was the most relaxed I have seem him in the last two days- he said the Rimadyl can take effect that quickly and that Boner is likely just finally able to relax and get some sleep now. I haven't been sleeping much because Boner hasn't been able to and I have been checking on him non-stop- so I think seeing him so relaxed now was almost a bit scary because I've been used to seeing him in pain over the last couple of days. That may not make much sense, but I'm hoping now I can relax a bit knowing that he is relaxed. I told the vet that I would call early in the morning if I do end up needing to get the gabapentin. He said if the pain flares up tonight, I could try upping the tramadol from 1/2 tablet three times a day to 3/4 tablet three times a day- hopefully won't have to do that....he calculated that dosage based on his weight (14.6 lbs) and said it was very close to the limit. Sorry for all of the continual updates in this one post- I just want whoever reads this to have the most recent info. Thanks.
|
|
|
|
Post by Pauliana on Mar 5, 2014 21:28:13 GMT -7
Hi Cal,
Yes please do give Rimadyl with a meal. We gave Tyler his Gabapentin and Tramadol at the same time. It should be ok to use the Gabapentin that you have, if you see his pain is still not under control. it hasn't been expired that long and it has been sealed. Your Vet said it should be ok.. From the sound of it the Rimadyl has kicked in and it may not be necessary.. I hope that's the case..
Fingers crossed.. Keep watch on that tummy..
It sounds like now that the Rimadyl has kicked in and he's getting some sleep..You also need your sleep and you aren't getting much judging from that medication schedule. 8am, 4pm and Midnight for Tramadol should get you more sleep.
What to watch for with NSAIDS such as Rimadyl: Any one sign is enough to STOP giving the drug to your dog and call your veterinarian immediately! Not eating or eating less. Lethargy, depression, changes in behavior, Vomiting,Diarrhea, red or black tarry-colored stool,Yellowing of gums, skin, or the whites of the eyes,Change in drinking, Changes in skin (scabs, redness, or scratching)
Prayers for Boner and hope he feels much better very soon..
|
|
StevieLuv
Helpful Member 
Conservative Treatment 3x. It really does work!
Posts: 1,335
|
Post by StevieLuv on Mar 6, 2014 7:53:36 GMT -7
Hi Cal, just catching up here. I am so sorry that Boner is going through this again. Glad to hear that his pain meds are kicking in and he can get some rest. I understand how much of a bummer it is to have this happen AGAIN, especially when you have been so diligent. Hang in there and know that you can get through it. We're here for you |
|
|
|
Post by Cal & Boner on Mar 6, 2014 16:59:50 GMT -7
Hi all,
So, last night Boner seemed pain free, but today he is shivering again. I took him in to have his second laser treatment and he also had his second dose of Rimadyl today. Here is the problem. As I mentioned above in my last post, I have Gabapentin from last year that I never had to use. It had to be compounded for Boner by a pharmacy and each one is a 35 mg chew that is individually sealed. They have not been exposed to any heat and have just been kept at my home. However, the expiration date was 10/13/2013. So, they are about 5 months past the date. My vet said they should be OK to use, and Wedgewood Pharmacy said not to use them (as I expected they would).
Today, I planned on going ahead and getting new ones made and sent to me- so I called Wedgewood Pharmacy today and they said even if I get the vet to call it in this evening, it takes 48 hours to make them and then they could overnight them, which means they would not ship out to me until Monday, and I would not receive them until TUESDAY.
So, I am stuck as to what I should do! I want to get as many opinions as I can regarding whether or not it would be OK to go ahead and give Boner the Gabapentin that I have even though it has a stamped exp. date of 5 months ago...if I shouldn't give him these- what can I do? I can't wait until Tuesday to get the new ones...Will the Rimadyl possibly continue to decrease the inflammation and thus the pain in the next couple of days...?
PLEASE HELP- I need as many opinions as possible! I can't take being unable to do anything about this! Thank you all so much.
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Mar 6, 2014 17:10:50 GMT -7
Cal, you need to get Boner's pain under control tonight. The vet has already given his OK about giving Boner the Gabapentin that you have. So please give him that. You can then go ahead and place an order for a fresh supply if you'd feel better about that. But meanwhile give him what you have since the vet said it's OK.
The vet had also said that you could increase the Tramadol from 1/2 tab 3x/day to 3/4 tab 3x/day. Have you done that yet? If not, please increase the dosage of the Tramadol also.
Prayers for a pain-free night for Boner. Please keep us updated.
|
|
|
|
Post by Jean & Mimi on Mar 7, 2014 9:11:30 GMT -7
Cal, how is Boner doing today? Have been thinking about you.
|
|
|
|
Post by Cal & Boner on Mar 7, 2014 10:57:17 GMT -7
Hi everyone, I was up with Boner again all night last night, worried as can be. He is still in pain (shivering) and arching his back a bit. I began his increase of Tramadol last night to 3/4 of a 50mg tablet every 8 hours. I also began his gabapentin last night taking one 35mg chew every 8 hours. Since he was still in pain this morning, I took him to an urgent care visit at the vet and luckily was able to see the doctor who has been the most familiar with Boner's case since last year. We did x-rays today to see if there were any changes since last year. The one disc from last year's x-ray showed just the slightest increase in mineralizatio. The only change was the disc right behind that one- it was also starting to show slight mineralization- that was not present last year. These are both close to the very back of Boner's spine. The vet told me I could increase the ▲ tramadol 3/4 of a 50mg to every 6 hours- so that would be tablet every 6 hours. He also said I could increase the
▲gabapentin 35 mg chew to 2 chews every 8-12 hours instaead of 1 chew. He recommended that I start with 12 hours first. I also went ahead and ordered a fresh batch but they will not be here until Tuesday of next week. He also said I could increase the ▲ Robaxin to 125mg every 8 hours- so that would be 1/4 of a 500mg tablet every 8 hours. I asked if surgery may be a consideration. He said that usually they don't want to do surgery unless there are neuro signs- but, if the dog can absolutely not get out of pain, then surgery can be done. Today is only the third day on the Rimadyl, so he said that it will continue to work on the inflammation. Is that correct? He said to give the new pain dosages a try over this weekend and give the Rimadyl some more time and then see how he is Monday (of course I can always go to an emergency visit on the weekend as well if needed) I live in Panama City, FL so my two options if surgery does become necessary are Auburn and University of Florida. 1.)What do you all think about the new dosages of the tramodol and gabapentin- Boner is a little over 14 pounds. I am always scared to up dosages of his meds... and he said I could up all three pain meds- that makes me NERVOUS! 2.) Is it safe for me to give it a couple of more days to try and get the pain under control? 3.) If the pain is still not controlled by Monday, should I consider surgery? And, if so, any recommendations on Auburn vs. University of Florida for surgery...? Thank you all so much- I am a mess, needless to say, and appreciate all of your feedback and support so much. And thank you Jean/Mimi for your concern |
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,579
|
Post by PaulaM on Mar 7, 2014 16:54:14 GMT -7
Within an hour IF the pain meds are right for Boner, pain will be brought under control and stay that way dose to dose. If you don't see his pain being relieved, you need to get back on the phone and let the vet know. Pain is the one part of healing we may not have any patience with. Michael Richards, DVM explain why the need to be aggressive with pain meds: When pain relievers must be given after an injury has occurred it sometimes takes much higher doses to tamp down the pain and get it under control. It is good to keep this in mind, because many people make the mistake of using low doses of pain reliever initially, hoping they will work. It is probably better to start with high doses and then to cut the dosage if it becomes apparent that lower dosages will work.
Another way of thinking about it [pain] is like a seesaw. You can put a rock on the high end of seesaw and it might not cause it to go down. If you add a second rock that might not move it, either. But eventually you will reach the point where the weight on the upper end suddenly causes the high end of the seesaw to fall. This is how pain threshold works. You really don't feel pain even though something has the potential to cause it until there is enough "weight" to tip over the pain threshold -- then you feel it suddenly.
www.vetinfo.com/dpain.html
Do be aggressive with the higher dose and intervals (every 8 hours for Robaxin and gabapentin) prescribed. Poor Boner has been so undermedicated for pain, he really needs the beneift of this new Rx.
Board-certified neuros (ACVIM) and ortho (ACVS) surgical specialists can be found at the two University vet teaching hospitals you mentioned which we have heard very good reports on. You can locate others in your area here:
www.acvim.org [neuros]
www.acvs.org/AnimalOwners/DiplomateDirectory/ [orthos]
As always you will want to be well read on meds Boner is on:
Gabapentin: vasg.org/g_drugs.htm#GABAP
Tramadol: vasg.org/t_drugs.htm#TRAM
Robaxin: www.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspx
|
|
|
|
Post by Cal & Boner on Mar 8, 2014 1:56:45 GMT -7
Hey everyone, Yes, the reasoning behind the vet starting at the lower doses was because those were the doses that worked for Boner last year during his first episode. I think we both thought (or hoped) that the same combo would work again this time. But, I now know every disc episode is different- and this one is a bit more challenging. Here is Boner's med list now: 14.5 lbs Tramodol- 37.5 mg - 4 times a day Gabapentin - 70 mg - 3 times a day Robaxin - 125 mg - 3 times a day Famotidine - 5 mg - 2 times a day Rimadyl- 25 mg - once daily Last night, I noticed that when I added the extra dose of Robaxin (he was getting 2 a day, now he is getting 3 a day), within 30 minutes, Boner was completely relaxed and sleeping. When I began the new dosages above yesterday afternoon, Boner got a dose of gabapentin, robaxin, and tramodol bewtween 3:00 PM and 5:00 PM. By 5:30 PM, he was so relaxed and it was such a relief! He slept and relaxed until about 9:30/10:00PM. Then I noticed some breakthrough pain (shivering). His next dose of Gabapentin and Tramodol was due at 11:00 PM and the Robaxin at 12:30AM. Sure enough, about 30 minutes after I gave him the next Robaxin at 12:30 AM, he was relaxed and sleeping again...so I will wait and see if the breakthrough pain happens again. To me, it seems that the Robaxin is what is helping the most...does that seem correct? If he does have breakthrough pain again, can I up the Robaxin to 125 mg 4 times a day instead of 3 times a day? (Again, he is about 14.5 lbs.) Thanks everyone |
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Mar 8, 2014 5:47:05 GMT -7
Robaxin deals with the pain caused by muscle spasms. According to the following site, it can be dosed at 150 mg per lb per day so the vet can increase each dose given: www.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspxAlso, we usually see Tramadol dosed at 50 mg 3x/day so that can be moved up, too. If that doesn't work, it can be given every 6 hours. I wouldn't wait to see if the pain happens again. Happening once is enough to call the vet. The sooner the pain gets under control, the sooner Boner's healing will start and he can continue his crate rest in comfort. It does look like he's getting close to finding the correct mix of meds! You can also check with the vet when you speak to him today not only about increasing the meds right now but what you can do should you see signs of pain late tonight when he can't be reached. It's always good to have a back-up plan. Prayers for complete pain control for your buddy. Please let us know what the new med dosage will be. |
|
|
|
Post by Cal & Boner on Mar 8, 2014 22:47:05 GMT -7
Hi everyone, Boner has been pain free since I upped his▲ Robaxin this morning from 125 mg 3 times a day to 187.5 mg 3 times a day. If he does happen to have pain again, is it correct that I can up his Tramadol to a whole 50mg tablet every 6 hours (right now he is taking 3/4 of a tablet every 6 hours). Also, Boner ended up having just two laser treatments last week. Would it be beneficial to take him in this coming week for another round of them- even if he is not in pain? I know they promote healing- so I want to do everything that I possibly can. Thanks again so much |
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Mar 9, 2014 6:08:01 GMT -7
I believe your vet said Boner was "close to the limit" with his dosage of Tramadol so there might be some room to move that up. You would have to consult with your vet about going any higher on the Tramadol. I hope you've also discussed the increase of the Robaxin with the vet - if not, be sure to let the vet know that you've increased it. We're not vets and cannot prescribe medication, only share our experience. Hopefully, that increase in the Robaxin will continue to keep the pain under control. So glad to hear that he's been pain free. You've been a very strong advocate on Boner's behalf - kudos on your persistence in getting his pain under control! Yes, laser treatments do promote healing so if you want to continue with those, they are a good additional treatment. www.dodgerslist.com/literature/healingacupuncture.htm |
|
StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
|
Post by StevieLuv on Mar 9, 2014 20:23:59 GMT -7
Wonderful news that Boner's pain is under control. Kudos to you for being persistent!
|
|
|
|
Post by Cal & Boner on Mar 10, 2014 16:27:46 GMT -7
Hi everyone, Boner went in for his third laser treatment today and will be having the fourth one tomorrow. I have not seen anymore breakthrough pain today- but last night he would shake for a short time in his cage after I would take him out to the bathroom- and then he would relax again. Tomorrow was supposed to be his last day on Rimadyl but the vet wants to keep him on Rimadyl and his other meds for another week. Last year, he was only on Rimadyl for one week, so I am a little nervous about him being on it for two- and along with all of the other meds too. Does anyone have any thoughts about him being on all of this for two weeks? Should I try to decrease the pain meds at any point over the next week? Also, Boner's new gabapentin came in today which was sooner than expected. So I have switched him to the new ones at the same dose- but now I am wondering if maybe I should decrease the dose of the gabapentin since maybe it is stronger than the old ones I had been giving to him...any thoughts? I have also noticed that since this started last week, he does not want his hard food that he normally eats- I have been having to wet it a little bit- and then he eats it fine. I do recall that, last year, he did this as well for a little while. Is this common? It seems like maybe he does not want to have to crunch down on the food and that is why he wants it a bit soggy...? Is this something I should be concerned about... Thanks everyone for all the support and encouragement- one day at a time |
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Mar 10, 2014 17:34:56 GMT -7
Cal, shaking after coming in from doing potty could well be a sign of pain. Is it very cold where you are and could the shaking be from being cold? If not, movement does cause pain and the movement of going to potty could be causing the shaking. So no, you should not decrease any pain meds. In fact, if the shaking is not from the cold and is indeed from pain, you'll need to speak to the vet again about adjusting the pain meds as they are still not correct. Swelling in the spine can take 1-2 weeks to up to a month or more to resolve. Until all swelling is gone, an anti-inflammatory is needed. Two weeks is not a long time for Boner to be on Rimadyl and I'm very glad that the vet wants him on that for another week. Are you protecting Boner's GI tract from the side effects of the Rimadyl by giving him 5 mg of Pepcid AC 30 minutes before the Rimadyl and every 12 hours thereafter? Did the vet say anything about this being a disc in the neck rather than the back? In looking back through your postings, I saw where the vet didn't find any pain in the back. Boner's reluctance to eat his hard kibble would indicate that this may be a neck problem. That would also explain why it's been so difficult to regulate his medication. Neck problems can be much more painful than back issues and can take longer to resolve. Is Boner reluctant to move his head or does he hold his head in an unusual position? Here are some tips that can be used with dealing with a cervical issue, such as softening his kibble and raising his food/water dishes so he doesn't have to bend down: www.dodgerslist.com/literature/cervical.htmPlease let us know whether you think the shaking is due to the cold or pain. |
|
|
|
Post by Cal & Boner on Mar 10, 2014 21:13:40 GMT -7
Hey Marjorie- thank you for the response- He has shown no signs of neck pain- other than like I mentioned- not wanting to eat hard food. Could he be having some sort of oral pain maybe...or just not be as eager to eat his food because of all of the pain meds he is on?
He has been pain free today from what I can tell. The vet did x-rays on him but I am not sure if the x-rays included the neck. I looked over them with the vet, but I think they were just of his back area where we focused on the the two discs... I will double check tomorrow when I go in for his laser treatment and mention the food issue to my vet. If they didn't do an x-ray of the neck area, I will probably go ahead and have that done to make sure. If it was his neck, wouldn't there definitely be other indicators- like not moving his neck/holding it strangely as you mentioned...?
And yes, he is getting the Fimotidine every 12 hours and 30 minutes prior to Rimadyl.
Also, is it correct that in order to do x-rays of the neck- Boner would have to be put under light anesthesia?
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Mar 11, 2014 7:25:36 GMT -7
If he's showing a loss of appetite and not wanting to eat his food, that could be a red flag sign of a GI tract problem. Sometimes even with Famotidine, a GI tract can start and Sucralfate needs to be added. However, if Boner is eating his food when softened and just rejecting the hard food, that could indicate a neck problem. It might be hurting his neck to bite down on hard food. He may not be showing any other neck symptoms due to the pain meds masking the pain. I would try the tips for a cervical issue anyway, like raising his food/water dishes. Neck injuries are more difficult to treat because it's more difficult to keep the neck from moving. I would take those extra steps just to be sure.
I haven't heard that dogs need to anesthetized for neck x-rays. X-rays are good to rule out other problems, such as tumors, fractures or infections of the bone but are not used to definitely diagnose a herniation or tear, which is soft tissue. Diagnosis of IVDD is usually made based on symptoms. An MRI or CT scan are the only ways to definitely diagnosis IVDD and those are usually done only prior to surgery. If the vet wants to anesthetize Boner for a neck x-ray, I would pass on it as anesthesia can put his back at risk because his core muscles are all relaxed. With conservative care, it doesn't really matter what disc is effected as the treatment would be the same. There are some added steps that you can take to ease the neck shown on the link I gave to you.
I'm glad Boner is pain free today. Keep an eye on that shaking, though, and if it returns, let the vet know.
|
|
I will let you know any updates. Thanks so much again.
