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Post by Ken & Ellie on May 13, 2014 17:33:11 GMT -7
Hi ,I have a five year old Lab which all of a sudden starting with a episode one evening , you could tell she was in pain but it went away in a short time. She had been acting docile after that time but we started thinking she may have Lyme because we found a tick on her about 20 some days prior and the time frame and symptoms had us thinking that. We took her to the vet and had her checked and test came back neg. and the vet thought she may have a pinched nerve and she was put on prednisone and tramadol. After two days there was no improvement and my wife still felt that it was Lyme, so we took her to another vet we see. When we saw the other vet they did a back X-ray and thought there was arthritis and was told to keep on meds the other vet prescribed but added muscle relaxers. 5 or 6 days later she kept getting worse so we took her back and they did neck X-rays and these show a sign of something at the spine in the front shoulder , which she said could be a bad disk ,but would not say for sure without her going to a neurologist and a MRI. There are only two in the state which are nowhere close and finances are very tight. She is on
80 lbs
prednisone 20 mg. [as of 5/8] 2 twice a day for another two days then one until directed otherwise.
Methocarbamol 500 mg. 2 every 12 hours.
Tramadol 50 mg. twice a day.
During all this time she was never instructed to strict crate rest. Last weekend I started research on the web and everything said to keep crated and quite so I immediately started crating her and the only time she is out is feeding and potty. She is 80 # and can not be carried out so she has to walk,but only to do her duty than right back in the crate. I built a long ramp so she does not have to climb the couple steps to the house. You can tell she is in extreme pain and very uncomfortable and we are not seeing any improvement. Our hearts are broke. Any suggestions? She went a long time before she was put on bedrest. Every time we would take her to the vet she would jump into the vehicle and then at the vet you would not know there was any problem with her because the adrenalin would be kicking in and I know this was not good for her.
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Post by Pauliana on May 13, 2014 19:13:25 GMT -7
Welcome to Dodgerslist. First thing to know is that it IS in the cards for your dog to get back to enjoying life after recovering. 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. Are you ready? Here's the link www.dodgerslist.com/healingindex.htm 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 www.dodgerslist.com/store/DVDorder.htm Tape this flyer to your fridge so the whole family knows what things are emergencies: www.dodgerslist.com/literature/FridgeInfo81907.pdfIn order to help you more, could you please answer these questions? ► What is your your name? ► What was the date you saw the vet and started the all important 100% STRICT crate rest 24/7 only out to potty for this current disc episode? …. STRICT means 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)? ► Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy? More on crate rest: www.dodgerslist.com/literature/CrateRRP.htm► Please include the all important stomach protector such as Pepcid AC. Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog 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 anti-inflammatory. It's very important that you continue Ellie on the anti inflammatory dose of the Prednisone since she is still in pain. Do not start the taper in two days. Call and talk to the Vet about continuing on the twice a day dose for longer.. Keep in mind that many dogs need 7 to 30 days at the twice a day dose to get rid of the swelling and inflammation that is causing the pain.. Since she is still painful now is not the time to taper. www.dodgerslist.com/literature/healingsweling.htmTramadol twice a day will not handle the pain. It has a short half life and it is much more effective at every 8 hours. Discuss this also with your Vet. www.dodgerslist.com/literature/healingpain.htm► Eating and drinking OK? Poops OK - normal firmness & color -no dark or bright red blood? ► If there is pain or neuro diminishment, dogs can benefit greatly with acupuncture or laser light therapy. These therapies can be be started right away to help relieve pain and to also to kick start energy production in nerve cells to sprout. So if this therapy is in your budget, seek out a holistic vet. ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] Chiropractic is not recommended for IVDD dogs Keep her from jumping into and out out of the car. That can damage her early healing disc. Take along a portable ramp since she is too heavy to lift. Bless you for building her a ramp for going outside! Sending comforting and healing thoughts your way for you and Ellie.. |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
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Post by PaulaM on May 14, 2014 6:56:20 GMT -7
kp, I would like to add to the good information Pauliana has already pointed out. Because you can't carry Elie, please see if you can get her meds adjusted over the phone. Anytime she is moved, has to walk, the disc suffers pressure from the vertebrae. There is no one size fits all pain relief, it may take feedback of your observations of pain so that the vet knows there is a need to further adjust meds in dose of mgs, or how often given or even to add in yet another pain med. Discuss with the vet about giving methocarbamol 3x a day as well as Tramadol 3x a day. 50 mgs of Tramadol is a VERY, VERY light tentative dose for a 80 pound dog. With a disc episode pain meds need to be aggressive. I would also discuss adding in gabapentin. This med works synergistically with Tramadol and vets are finding very good success with hard to control pain. Let us know the date that pred started. Remember as Pauliana wrote, it can take 7-30 days to get all the painful swelling down, so do not be dismayed if another course, an extended course of pred is needed. As long as there is painful swelling it is not the time to try a test taper to see if the swelling has been resolved. Not having been on 100% STRICT crate rest 24/7 only out at potty time for just a very few footsteps from the start means that disc could not heal there was too much movement going on causing set backs. Because neck discs can be particularly painful, this page will provided the extra things you can do to help: www.dodgerslist.com/literature/cervical.htmCAVEAT: It is important to do your own reading about meds so you can participate in discussions. The reason for you to not self prescribe is your vet has responsibility for the health of your dog in meds he prescribes based on his exam, the health history of your dog, how meds interact, not things we or you might know as we are not veterinarians. If you are not satisfied with how your vet handles this disc episode, then there is a need to hire a different vet who is comfortable in treating a disc episode. vasg.org/g_drugs.htm#GABAPvasg.org/t_drugs.htm#TRAMwww.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspxWe look forward to learning more about Elie with the answers to the questions Pauliana asked. |
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Post by Ken & Ellie on May 14, 2014 20:12:42 GMT -7
First I want to say thanks for your concern and compassion . My name is ken peters. Our first vet visit was on 4/30 and she was prescribed the prednisone and tramadol then we went to the other vet on 5/2 and had the first back X-ray and was given a chondroitin shot (which seemed to help) then she started getting real bad and was taken back on 5/8 and blood work was done (which came back good) and increased her prednisone and added the methocarbamol . Then was taken back the next day X-rays and that was the one showing the bad spot. She was put on crate rest this past Sunday 5/11. She is still in bad pain at times. I will talk to the vet about her pain med schedule. She is eating ok but today is the first day that she has not pooped and we are very concerned about that. She has had normal looking stools. Should I give the Pepcid once a day? There are also times when she pants real bad ,is that from the pain or from the meds?
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Lola & Hurley
Helpful Member 
2 paralyses, 3 surgeries, 2 conservative treatments. Now walking :)
Posts: 135 
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Post by Lola & Hurley on May 14, 2014 20:53:39 GMT -7
Hi Ken, and welcome to the site. You have taken the necessary first steps to ensure Ellie's recovery - well done! Now, it is time to get immersed in the information on this site so that you can help her further.
You say she is still sometimes in pain. That means that the pain medication is not working or aggressive enough. As you noted, you should consult your vet(s) as soon as you can, and discuss adjusting the doses and frequency of the medications. Vets who are knowledgeable about IVDD will not hesitate to adjust the medication and/or suggest another frequency (for example: every 8 hours instead of every 12 hours). The medication prescribed thus far seems to be correct, so your vet(s) seem to be on it and I'm sure they will work with you to find the correct schedule. Also ask them about adding the Pepcid (as instructed by Pauliana, see above) and explain the panting. Some dogs react to Tramadol by panting, but that's not necessarily the cause - panting can also be caused by pain or general discomfort. I recommend writing all that you notice down when it happens along with the medication schedule so that you have a full list of information to give to your vet. They will appreciate the details (as do we)!
Regarding the stools. If you feed her dry food, you can soak the kibble with an equal amount of water before feeding. Be sure she drinks enough during the day. At Dodgerslist, we recommend dogs should take in 20-40 milliliters per pound of body weight per day. You can also try the magical fruit pumpkin! The fiber in pumpkin, along with water, will soften stools. For a lab, you could start with a couple of teaspoons canned, plain, pureed pumpkin (not the kind with sugar!) mixed in water + food, one time per day and see if it helps.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
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Post by PaulaM on May 15, 2014 9:01:18 GMT -7
Ken, it appears that Ellie is now on a taper of Prednisone down from the anti-inflamamtory dose of 20 mg 2x a day started on 5/18. Thus the taper is likely the obvious reason for the pain you see. It is on the taper that if you see ANY hint of pain, the vet needs to know asap. Often it takes being at the anti-inflammatory dose of prednisone for 7-30 days. Starting crate rest later than sooner may be necessarily extending the time it takes to get the spinal cord swelling down. When the vet guesses swelling might be gone there will be a call for a taper. Usually the first course will be 5 or 7 days and then a test taper. Your vet gave a very short Prednisone course for 2 days (?) When 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. Since there is still pain there should be no taper...there is still much swelling for Pred to work on. Rule of thumb is: pain = swelling = more time on Pred, pain meds and Pepcid AC needed. As Lola indicated we can't have patience with pain. Because neck discs can be more painful and maybe take a bit longer to heal, please be a strong advocate that our vet be much more aggressive with use of pain meds: -- Advocate for Tramadol at a greater dose than 50mgs AND given at least 3x a day -- Advocate for Methocarbamol being given 3x a day -- Adovcate for Gabapentin to be added to the above pain meds mix. Vets are finding and we see it is true right on this Forum that there is much better control with hard to manage pain. These are the xtra things you can do to help with a neck disc: www.dodgerslist.com/literature/cervical.htmPepcid AC stays at the optimum level in the body when given every 12 hours. Give it 30 mins before Pred. And give Pred with a meal. Let us know what your vet is doing to get full control when you contact him this am. Please do give us an updated list with names, mgs and how often. We anxiously await hearing that Ellie's pain is under control in an hour and stays that way dose to dose. |
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Post by Ken & Ellie on May 15, 2014 11:51:45 GMT -7
I did not back her down on her prednisone today as we have an appointment with the vet tomarrow and we added a half dose of pain med mid day until we see the vet. I started with a Pepcid last night. You could tell that extra pain reliever helped because the tail was wagging?  . Will update after vet visit. |
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Post by Pauliana on May 15, 2014 20:13:56 GMT -7
Hi Ken,
Pepcid Ac should be given every 12 hours, 30 minutes before the Prednisone dose. So glad to hear that her tail is wagging. That's the miracle of pain relief, that midday dose is helping. Let us know what the Vet has to say after her appointment. Make sure her crate in the car is padded with rolled up blankets or towels to prevent her being injured if you go over bumps, around corners and have to stop suddenly.
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Post by Ken & Ellie on May 18, 2014 5:21:27 GMT -7
Hi All , vet visit went well. She was very receptive to my recommendations. This is where we are at now.
Pepcid twice a day,
prednisone 1 two times a day,
methcarbamol 2 @two times a day ( I need to verify with vet on 3x a day, we talked about 3x a day but I don't recall what she said and it was not on my instructions)
gabapentin 2 @ 2x a day for a week than 2@3x a day and goal of 3 @ 3x a day the vet wanted to work her into that dose.
Tramadol 3x a day. We are also giving 1 teaspoon of cod liver oil 1x a day and she is getting a chondroitin shot at 1.6 mg once a week but the vet said she could have 2 a week. The vet gave us info on a acupuncture vet and we will be contacting this week. She seems to be a lot more comfortable , panting has subsided and tail is wagging more. Will keep you informed. Thanks to all
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
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Post by PaulaM on May 18, 2014 13:57:18 GMT -7
Ken, glad to hear you have the meds on board and Ellie is comfortable. When you can would you fill us in on the dose in mg for each. And do let us know there is no pain at all surfacing nearing the next dose of meds.
What is the reason for cod liver oil? When on IVDD meds we really do not recommend adding oils, fats, changes in diet. If there is a symptom it should be clear whether serious action needs to be taken with vomit, diarrhea and not jut bide time with temporary supplement/food issues.
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Post by Ken & Ellie on May 18, 2014 16:22:45 GMT -7
The cod liver oil which she has been takeing for over a week is to help with a spot of what appeared to be some arthritis in her back and to help here with her rear leg which showed signs of hyperextention which we were giving her glucosamine/chondroitin tablets and the vet recommend the oil instead.
Pred @ 20mg 1 ,twice a day ,
methcarbamol @ 500mg 2 ,twice a day
gabapentin @ 100mg 2 twice aday for 1 week than 2 3x a day
tramadol [??mg??] 1or2 3x a day
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on May 19, 2014 4:19:00 GMT -7
Ken, please take a look at this link for more information about supplements. As Paula said, we don't recommend giving anything new while on meds since, if a symptom such as diarrhea or vomiting should arise, it would be difficult to know whether it was due to the meds or the supplements. This link will give you an understanding of Dodgerslist's position regarding supplements and their benefits for IVDD. www.dodgerslist.com/literature/Supplements.htmThere are no signs of pain at all now? The new meds should be keeping Ellie's pain completely under control from one dose to the next. What is the dose of the Tramadol? Healing prayers for Ellie. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
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Post by PaulaM on May 19, 2014 7:53:43 GMT -7
Ken can you tell us more about the rear leg hyperextension? Does it look like this dog's rear legs being hyperextended due to nerve damage.... he can no longer tuck his legs under himself.
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Post by Ken & Ellie on May 20, 2014 17:09:12 GMT -7
Hi, the tramadol is 50 mg pills. Her rear leg is normal. The problem happened about a year and a half ago. After we would play ball or out running in the woods with me she started gimping on her rear leg bad. Took her to the vet and they said is was not bad enough to justify surgery and we put her on pain med (meloxicam) as needed. We had her on the med for a half year or so and we ran into a former dog trainer that suggested glucosamine/chondroitin ,so we started giving her one a day, worked great ,was able to take of pain med.once and a while after a lot of activity she would favor it and we would give her a single pain med .we talked to vet a while ago and we talked about how we felt so good about the glu./chon. And the vet suggested the cod liver instead. Do you think all this crate rest will help with the healing of that problem? After she heals from the IVDD will she have to be on meds?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on May 21, 2014 5:13:29 GMT -7
Just want to add here a complete list of meds so we can refer back to it: 80 lbs Pred @ 20mg 1 ,twice a day , methcarbamol @ 500mg 2 ,twice a day gabapentin @ 100mg 2 twice aday for 1 week than 2 3x a day tramadol 50 mg 1or2 3x a day Meloxicam is not a pain medication - it's a NSAID (anti-inflammatory). Was there a wash-out period of 4-7 days between the last time she had a dose of Meloxicam and when she started the Prednisone? Pepcid AC should be given to protect your dog from the excess acid produced by the anti-inflammatory. 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. Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before the dose of the anti-inflammatory and thereafter every 12 hours. 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 her from taking Pepcid AC, then do get it on board. IVDD is a lifelong disease. Each time a dog with IVDD has signs of a disc episode (pain, limping, neuro deficits), an exam by a vet needs to be done to determine if the dog is having a disc episode. If it's determined that a disc has torn or ruptured, surgery or conservative care has to be decided upon. If the diagnosis is in doubt, then the safe approach is to treat as if an IVDD episode. Possibly it was arthritis a year and a half ago or a torn disc that was never treated properly. With conservative care, a full 8 weeks of 100% strict crate rest is needed, with an anti-inflammatory to bring down the swelling and pain meds. When the anti-inflammatory is tapered (if a steroid) or stopped (if a NSAID) and pain meds are stopped and there is no longer any pain/swelling, then no meds are needed. So once Ellie's pain is gone, which would mean that the swelling has resolved, and she would no longer need medication. The 8 weeks of crate rest will heal the injured disc. However, IVDD affects all of the discs of the spine and causes degeneration of the discs so another disc could rupture or tear in the future. You will need to learn all that you can about IVDD so you can know what signs to look for and how to protect her spine in the future. Here's a great place to start: www.dodgerslist.com/healingindex.htmIs Ellie's pain completely under control at this point? Pain hinders healing so have no patience with it. There should be no sign of pain from one dose to the next. Neck injuries can be much more painful than back issues. |
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Post by Ken & Ellie on May 21, 2014 19:19:16 GMT -7
I just wanted to confirm I am giving her Pepcid twice a day before her Pred and she did have 5 days between the meloxicam and the prednisone. Is there any of this med that can cause her to pant? Sometimes she will pant real heavy. Should she be taking the methcarbamol 3x a day?
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Post by Pauliana on May 21, 2014 20:36:31 GMT -7
Hi Ken,
Prednisone causes panting. You can put a fan near Ellie but not pointed right at her, to increase air flow around her. That should help.
Methocarbamol can be three times a day but always good to clear that with your vet...
Healing prayers for Ellie!
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. Will update after vet visit. 
