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Post by Wendi & Peanut on Mar 4, 2014 17:55:43 GMT -7
My little Peanut [Mini Dachshund 6 years old] was diagnosed last week and was given meds and I was told strict rest. I did not know what strict rest meant until I found information on the internet. It was not explained to me completely that he is on strict crate rest 24/7 and only can walk a few steps to potty....for 6-8 weeks? His meds are as follows...Clavamox which he took the last of this morning,
13 lbs
Tramadol 10mg every 12 hours,
Methocarbamol 500 mg every 8 hours,
Prednisone 5 mg every 24 hours for 7 days and then again and then tapered.
I just started the strict crate rest today.....you can tell when his pain meds kick in, he thinks he is feeling 'better'. But you can tell about 2 hours before it is time for another pain med because he 'shivers' and sits with his head down and you can tell he is in pain. Sometimes when we pick him up to take him outside to potty he cries in pain. We are being very careful to support him in the front and back and underneath. Any advice would be appreciated. This is a scary thing for my family and me and again we are new to this but in the hopes that this will 'heal' with strict rest and meds. Thank you for the opportunity to become part of your forum. Wendi |
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Post by Pauliana on Mar 4, 2014 21:07:18 GMT -7
Welcome to Dodgerslist Wendi! Please let your Peanut know with your utmost confidence that things are going to be ok…because they will. With this disease self education is critical not just so you make sure the right things are being done for the best recovery but for your own emotions. The unknown is simply a scary place. Get ready to fight this disease now and in the future by knowing all things IVDD. There is no better place to start than on our main web page with "Overview: the essentials" and then read all you can as soon as possible. Here's the link www.dodgerslist.com/healingindex.htmPeanut is in pain because the Tramadol is at a very low dose and Tramadol is far more effective given every 8 hours because of a short half life. "Tramadol has an exceptionally short half-life in the dog (1.7 hours) making it pretty useless unless it is given at least TID. (three times a day) It is not a good choice as the “sole source of pain meds”. It is quite good when it is used in conjunction with gabapentin." Methocarbamol works well with it also. Please discuss with your Vet right away to get Peanut comfort from pain, as pain slows down healing. He needs to be pain free from dose to dose and with some adjustments to his pain medications he can get back to the business of healing. www.dodgerslist.com/literature/healingpain.htmHas Peanut been on 5mg of Prednisone every 12 hours before going to the 5mg every 24 hours?? If not she has not been on the anti inflammatory dose of Prednisone which is so important to get the swelling down in the spinal cord. Once the swelling has been resolved she will be pain free.. It takes from two weeks and for some dogs more like a month on the anti inflammatory dose to get the swelling down. Cortisteroids (Prednisone, Prednisolone, Dexamethasone, etc.) are involved with stimulating gastric acid secretion causing GI upset to the more threatening bleeding ulcers or holes in the stomach or intestine. Phrase the question to your vet in this particular way: " is there any medical reason my dog may not take Pepcid AC?" If there is no reason, we follow vets who are proactive in protecting the stomach by giving doxies 5MG Pepcid AC (generic name is Famotidine) 30 mins prior to steroid. Pepcid AC is a generally safe over-the-counter suppressor of stomach acid production for healthy dogs. Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. We ask that all members read about each med their dog is on or may take as a safety measure. This directory is in alpha order: www.marvistavet.com/html/pharmacy_center.htmwww.dodgerslist.com/neurocorner2/stomachProtection.htmwww.petplace.com/drug-library/famotidine-pepcid/page1.aspxIn order to help you more, could you please answer these questions? -- How much does Peanut weigh? -- Can your dog move the legs at all or wag the tail due when you do some happy talk? -- Can your dog sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? Helpful videos with tips on expressing both urine and poop: www.dodgerslist.com/literature/Expressing.htm-- Eating and drinking OK? -- Poops OK - normal color and firmness no dark or bright red blood? Add 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; plus don't forget to order one DVD for your vet www.dodgerslist.com/store/DVDorder.htm Laser light therapy, acupuncture and electroacupuncture which sends a microcurrent of electricity to and from acupuncture points (which are really big nerve bundles), can be very beneficial at helping to re-establish the nerve connections in the body. Any one of these therapies can be started right away if in your budget... they not only help relieve pain and inflammation but will kick start nerves to begin regeneration. Find a holistic vet here: ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] NOTE: Chiropractic is not recommended for IVDD dogs. Sending soothing and comforting thoughts your way.. I know how scary IVDD is, I went through it with my Tyler and all I can say is learn all you can so you can advocate for your Peanut.. There is life and fun after an IVDD episode.. Tyler is living proof. |
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Post by Wendi & Peanut on Mar 5, 2014 6:07:34 GMT -7
Thank you Pauliana...you have no idea how much your response means to me. Please let me answer your questions.
In order to help you more, could you please answer these questions?
-- How much does Peanut weigh? Just a little over 13 lbs....
-- Can your dog move the legs at all or wag the tail due when you do some happy talk? Yes he can walk and wants to when his pain meds are kicked in...he will wag his tail if he gets excited too.
-- Can your dog sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? He was having pee accidents right after we would get home and leave him out of the crate, or he would get excited a pee a little on his bedding when we got home. But when we take him out (carrying him) he does lift his leg a little to pee and he does poops just fine. Right now they seem to be ok...
-- Eating and drinking OK? Sometimes he will stick up his nose to his food but it doesn't go long that he will eat most of it. And yes he will drink too.
-- Poops OK - normal color and firmness no dark or bright red blood? They started to get really stinky and some of the poop that comes out is like soft ice cream firmness. No blood that I can see...not dark either...just normal brown color.
I need to call the vet today to let them know that we won't have enough pills to last us through until our follow-up visit next week on the 11th. Which by the way...why would they want to see him back so soon? Would they want to do another x-ray or what? I do not have much choice in vets around here so i'm sort of stuck with whom I have. If I can call them 'armed' with the information you suggest to me that can only help Peanut i'm sure.
Thank you Again!
Oh...I forgot to answer your question about the Prednisone....He is taking one every 12 hours for 7 days and then every 24 hours and then tapered. We are still on the every 12 hours until tomorrow. These were started last week along with the other medications.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Mar 5, 2014 7:44:56 GMT -7
Wendi, you are still seeing signs of pain so a taper of the Prednisone should not start tomorrow. You need to contact the vet ASAP and let him know there are still signs of pain. Pain = swelling = more time on meds.
Also, Peanut's pain meds need to be adjusted. He is on a very low dose of Tramadol and as Pauliana said, Tramadol is most effective when given consistently every 8 hours. Gabapentin can also be added. There should be absolutely no signs of pain from one dose of the meds to the next. Pain hinders healing. Please contact the vet TODAY about adjusting Peanut's pain meds to get his pain fully under control.
Please also discuss TODAY with the vet about adding Pepcid AC to protect Peanut's GI tract from the side effects of the Prednisone. Developing soft poop is a red flag sign that a GI tract problem could be starting. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep him from taking Pepcid AC, then do get it on board.
Did the vet say anything about this being a neck issue? The fact that Peanut sits with his head down may be from pain in his neck. Does he have any difficulty turning his head?
Usually vets update meds and get updates on the dogs' conditions by telephone. I would tell your vet that you would prefer not moving Peanut too much and ask his reasoning for wanting a re-exam. Usually re-exams are done if pain continues after several tapers or if there is a worsening of condition. Peanut just needs his meds adjusted so his pain is under control and the continuation of strict crate rest for 8 weeks.
Healing prayers for Peanut.
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Post by Wendi & Peanut on Mar 5, 2014 9:45:47 GMT -7
Thank you Marjorie....I have a phone call into the vet office for her to call me back about his medications, etc. TODAY. When they xrayed him last week, they found a spot on his back about mid way and in his neck. So yes...a problem exists in his neck as well. They said that they didn't see 'white' so they didn't believe it was calcified yet and could be treated with meds and rest. They also checked his kidneys that day and everything was fine there. Yes....he DOES have difficulty turning his head most times....again...especially when his pain meds have worn off. What would be a good dose of Tramadol for his size/weight? Obviously it is not working to keep the pain at bay so with him being slightly over 13 lbs. do you have a suggestion so that I can talk to the vet about it? I certainly will ask about the Pepcid AC as well.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Mar 5, 2014 11:36:12 GMT -7
A very good source for information on meds, doses, etc. is the VASG.org website listed here: dodgerslist.boards.net/thread/951/dogs-medsBecause Tramadol has a short half life of about 1.7 hours, it often does not provide good pain coverage unless Rx'd every 8 hours. Since you are reporting pain has never been under control, it is clear it is not time to start a pred taper now. This is how Pred works: Often it takes being at the anti-inflammatory dose of prednisone (5mg 2x/day) for 7-30 days. When the vet guesses painful swelling might be gone there will be a taper. Usually the first course will be 5 or 7 days and then a test 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. Can you clarify that you are actually giving a whole 500mg methocarbamol tablet every 8 hours? www.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspx13 lbs Tramadol 10mg every 12 hours, Methocarbamol 500 mg every 8 hours, Prednisone 5 mg every 12 hours for 7 days, 3/6: again every 24 hours and then tapered. Pepcid AC ? |
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Post by Wendi & Peanut on Mar 5, 2014 12:36:52 GMT -7
The Methocarbamol 500 mg. pills are quartered. A quarter of this pill is being given to him every 8 hours. I apologize for not explaining that properly.
I did speak with the vet and we are now going to give the following to him....
10 mg. of Tramadol every 8 hours with the 1/4 pill of methocarbamol.
He is going back on Clavamox ...she wants him on it for 10 days.(He had a little bacteria in his urine and this is why the clavamox)
Prednisone hasn't changed....we are not on the taper yet.
And she agreed to the Pepcid AC with the prednisone....I'm going to use the suggestion from you folks to give the pepcid AC 30 minutes prior to the prednisone.
She said if changing the doseage of the tramadol doesn't ease his pain and let him rest more, then I am to call.
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Post by Pauliana on Mar 5, 2014 21:55:20 GMT -7
Hi Wendi, My dog Tyler was on 25mg Tramadol every 8 hours for both of his lumbar disc episodes.. A neck episode is even more painful.. Proper pain management is very important with Neck involvement.. Please read this about Cervical disc episodes. It has lots of tips on how to handle a cervical episode and how to get the pain under control. www.dodgerslist.com/literature/cervical.htmSo many prayers and comforting thoughts on the way to you and Peanut!! |
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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 Mar 6, 2014 7:39:41 GMT -7
Hi Wendi, my name is Maureen. You are doing a great job learning about IVDD and helping your Vet to learn about it too. Here's hoping that the pain medication adjustments work and Peanut has good pain control now. Keep us posted. Keeping you in thought and prayer.  |
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Post by Wendi & Peanut on Mar 7, 2014 7:38:14 GMT -7
Hello, I have a question. I read the area on the medications but I can't quite seem to understand something so I thought I would ask. Peanut has a return appointment with the vet on Tuesday the 11th. I understand that when we start to taper the Prednisone if we see signs of pain that we would probalby need to start back up on it again daily as it wasn't enough time on the anti inflammatory. However my question is with the Methacarbamol and the Tramadol. How long does he need to be on these? How would I know? I just would like more information on this so that I can be knowledgeable enough that if she says to discontinue these when I go in and he should still be taking them I would know enough to speak up. I do not think the vets in this office know of the serious of this and mentioned to me that being in the crate 24/7 was not necessary so i'm afraid that they might take him off medications that he needs longer. Can someone help me understand the duration of the meds? (other than the prednisone). Thank you!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 7, 2014 7:45:33 GMT -7
The medications have a two-fold use. The anti-inflammatory works on resolving swelling, which presses on the nerves of the spine and cause pain and possible nerve damage. The pain meds (both Methocarbamol and Tramadol) work on resolving the pain that the swelling is causing. Usually the pain meds are stopped when the Prednisone is tapered so a true test for pain can be made. If there is still pain during the taper, that would indicate that there is still swelling and more time is needed on all meds. If there is no pain at the completion of the taper, that would mean that swelling has resolved and there is no need for any meds at all.
Hope that helps. And I hope all goes well at your vet visit on Tuesday. Please let us know afterwards.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Mar 7, 2014 8:27:44 GMT -7
Wendi, adding to Marjorie's good explanation of why there is pain with a disc problem. This rule of thumb might be an easy way to keep those principles in your mind. pain = swelling = more time on Pred, pain meds and Pepcid AC needed. The "Why" behind the rule of thumb: Prednisone is the med that works over 7-30 days to get all the painful swelling down. Pain meds are used to mask pain so a dog will not be in discomfort during the time it takes Pred to work on swelling. Pepcid AC protects the GI tract against Prednisone A Pred taper is a test. Pain means not passing the test. Means all meds need to be back on board for a bit longer, before trying another test taper. |
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Post by Wendi & Peanut on Mar 7, 2014 9:54:22 GMT -7
Thank you both! this is easy to understand now. I will let you know how I make out at Tuesday's vet appt.
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Post by Wendi & Peanut on Mar 7, 2014 12:49:27 GMT -7
Well we are now having a bit of a setback. Peanut just cried and screamed in pain when I got him out to pee around 1:30 this afternoon and he is hanging his head funny again. Will we have these episodes off and on or do I need to get meds adjusted again? I called the vet and am waiting for a phone call back. I do not want him to go the weekend in pain. And here he had a great day yesterday...rested quite well in his crate. He is also doing the 'shivering' thing again which tells me he IS in pain.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Mar 7, 2014 17:41:15 GMT -7
Wendi, the pain meds are obviously too low. Your vet is kinda tentative about being aggressive with pain meds. Neck disc just are more painful and need an aggressive pain relief approach. We can have NO patience with pain. It should be controlled in the hour when pain meds are correctly Rx'd and stay in control there after dose to dose. As always read and self educate on Peanut's meds so you can participate in strongly advocating and discussing things For a 13 pound dog IF Rx'd --- tramadol could go to 50mg 3x day. vasg.org/t_drugs.htm#TRAM--- Robaxin www.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspx --- Gabapentin is being found by vets to be successful with hard to control pain by adding to Tramadol and Robaxin. vasg.org/g_drugs.htm#GABAPMost all pharmacies carry a 100mg capsule (the smallest size it comes in)... just call around your local pharmacies for the best price and have your vet call in the Rx. Dscuss with your vet about Rxing 3x a day so that the needed level of gaba stays in the system (elimination half life in dogs is 3-4 hours www.ncbi.nlm.nih.gov/pubmed/3730018) As an example if Rx'd 33mg of gabpentin 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!  |
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Post by Wendi & Peanut on Mar 10, 2014 13:15:26 GMT -7
Here is where we are as of today with Peanut. As of Friday night I was able to speak to the vet and we started Peanut on
▲prednisone (same mg as before) [5 mg] except every 12 hours
(he takes 5 mg of Pepcid AC 30 minutes before each dose).
He takes the Methacarbamol [125 mg] every 8 hours.
Tramadol (same mg as before) [10 mg] every 8 hours.
He has rested well all day Saturday and yesterday and my mother reported he seemed rather content when she gave him his pills this afternoon and took him out to potty. I have an appt with the vet tomorrow afternoon. I am crossing my fingers that we are now on the way to starting to 'heal' with his strict crate rest for 6-8 weeks. Will keep you posted. Thank you!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 10, 2014 17:13:30 GMT -7
Good job on advocating on behalf of Peanut, Wendi. 5 mg of Prednisone 2x/day is the anti-inflammatory level, so I'm very glad Peanut has been started on that. He's still very low on Tramadol so if he shows any signs of pain at all, the vet can increase that.
Please let us know how the vet visit goes tomorrow.
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Post by Wendi & Peanut on Mar 12, 2014 11:39:52 GMT -7
Just a quick update on Peanut. We had our vet visit yesterday. He is still on the pred. 2x/day for a day or so yet and then we start the once every 24 hours. We are keeping him on the Tramadol and Methacarbamol until the prednisone is stopped. Does that sound about right to you folks? I told them about the strict crate rest we have him on. Peanut 'thinks' he is feeling much better too because when I open the crate to get him out to potty, he wants to jump out and you have to be quick to stop him. He is pottying outside like normal but he is having some accidents here and there in his crate which is not like him. I mentioned this to the vet and they said that they hoped everything would be back to normal with him once he is off all the meds.....hmmmm. He walked around a little more in the vet office then what I have been allowing him too even when he is outside to potty so I thought it would be a total setback last night or today but he seems 'ok'. But...he is definately still on strict crate rest and will soon be looking into tapering the pred.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Mar 12, 2014 13:21:39 GMT -7
Once pred is tapered it is no longer on the anti-inflammatory level, not working well to get swelling down. If Peanut remains on pain masking pain meds, how do you determine if there is still painful swelling left that the steroid (prednisone) needs to work on, the ability to recognize this pronto? How is the taper a clear test of pain when a dog is still on pain meds, that have not been backed off or stopped on the taper?
What is the date Pred is to be lowered (tapered) to less than the anti-inflammatory dose?
Do you think the accidents are because of not getting him out to potty more frequently (every 3-4 hours) while on Pred?
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Post by Wendi & Peanut on Mar 13, 2014 6:36:48 GMT -7
He is on the antiinflammatory dose of prednisone until Saturday, March 15th. Then we start 1 pills every 24 hours. Should I discontinue the use of the Methacarbamol and the Tramadol about the same time or start to do that now then so we can see if he needs to be back on the pred. twice a day again for a little while longer?
I'm not sure what the accidents are from. Possibly you are correct. I leave at 7:00 in the morning and then my Mom can't get there until he is ready for his 8 hours dose of Methacarbamol and Tramadol at 1:30. Then we get home around 5:15-5:30 just in time for prednisone and such and supper. We have had 'accidents' at all different times. So the prednisone may increase his pottying?
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Mar 13, 2014 6:57:11 GMT -7
Prednisone causes increased thirst and urination. He would need to potty every 3-4 hours while he's on the Prednisone.
Usually all pain meds are stopped when the taper of the anti-inflammatory starts so if your vet has told you to discontinue the pain meds with this taper, then the Methocarbamol and Tramadol should be stopped on March 15th. At that point, with all pain meds stopped and the Prednisone starting to taper, you need to be on the lookout for any signs of pain. If you do see any signs of pain at any time during the taper, you'll need to immediately contact the vet so Peanut can be returned to all meds and the anti-inflammatory dosage of the Prednisone. Pain = swelling = equal more time on meds. Continue to give the Pepcid AC every 12 hours as long as Peanut is on the Prednisone.
Prayers for a successful and pain-free taper for Tater.
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Post by Wendi & Peanut on Mar 18, 2014 3:48:50 GMT -7
Well so far so good. I actually waited one more day to start to taper the prednisone. He has now been on the taper for two whole days...we are starting our third. He is off the Methacarbamol and the Tramadol. I still have him taking a Pepcid AC every 12 hours though. Still on crate rest even though you have to remind him occasionally that he needs to stay on crate rest. Pottying normal and he seems to be doing just fine....I'm crossing my fingers! Will keep everyone posted! Thank yoU!
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Post by Wendi & Peanut on Mar 26, 2014 15:55:31 GMT -7
peanut is doing well. Still on crate rest but going stir crazy. He is on the every other day prednisone now. He seems to be doing well and wants out! ha ha Is it possible to leave him out early since he is doing so well or should I stick it out a few more weeks to be sure?
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Mar 26, 2014 16:54:38 GMT -7
Though it's tempting when a dog starts feeling better to think they're healed, a damaged disc takes a full 8 weeks to heal and form secure scar tissue. Graduation day for Peanut is 4/29. He needs to be on 100% strict 24/7 crate rest until that date, carried in and out to potty with as few steps as possible. Too much movement before 4/29 and the disc could re-tear and you'd be back to square one, starting crate rest all over with Peanut back in pain and possible further nerve damage. Please commit to the full 8 weeks of crate rest. Please continue to observe for signs of pain during this taper of the Prednisone. There is no way of knowing whether there is still swelling under the Prednisone is completely stopped. Even if there is no pain after the Prednisone is stopped, Peanut still needs to remain on crate rest until 4/29. Hang in there - graduation day will come and you'll know that you've done your very best for your boy. |
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