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Post by Tara & Henry on Jun 11, 2014 16:19:46 GMT -7
Hi everyone.
I'm Tara and I have a 10 year old doxie named Henry .
He was seen by vet on 4-21-2014 Henry was perscribed
Methocarbonal 500mgs a 1/4 a pilltwice a day,
Tramadol.50mgs 1/4 to 1/2 a pill twice aday and
prednisone 5mgs twice a day then tapering down .
Plus crate rest . Henry was on crate rest for 3weeks my vet said Henry no longer needed crate rest. On 6-10 Henry yelped in discomfort .So back in his crarte
back on the
pain med
muscle relaxant
no prednisone
I need to know what to do ? Henry shows no signs of paralysis ,no weakness just discomfort/pain at his tail end.His appitite is goodand his attitude is good . Thanks for all your input . Tara and Henry
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,579
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Post by PaulaM on Jun 11, 2014 18:30:11 GMT -7
Tara, welcome to Dodgerslist. I'm so sorry to hear of this relapse. The entire purpose of the crate rest part of conservative treatment is this is the only way the disc has of healing. It takes 8 weeks of 100% STRCT crate rest 24/7 only out for a very, very few footsteps at pottytime. You will want to bone up on the purpose meds serve and how long they should be on board. -- Anti-inflammatory www.dodgerslist.com/literature/healingsweling.htm-- Pain meds www.dodgerslist.com/literature/healingpain.htmIf there is pain (shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy, not normal perky self), then the pain meds are not yet right. IF there is pain then it is caused by swelling/inflammation. Therefore prednisone or a non-steroid anti-inflammatory should be on board to get the swelling down as you will have read in the above two links. Let us know specifically what you are observing as pain. How much does Henry weigh? |
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Post by Tara & Henry on Jun 12, 2014 17:55:20 GMT -7
Hi, Henry weighs 16lbs . I also had some more questions .
In your opinions should I ask about pepcid even though Henry does fine on his Tramadol,Methocarbonal and prednisone ? How do take care of Henry when he is crated and I have to go work and do errands ? How do I decide what is best for Henry ? My vet says one thing and everything I read says something different .
example would be my vet says crate rest for 3weeks everything I've read says 8weeks .
Thansk again from Henry and his mom Tara
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Post by Pauliana on Jun 12, 2014 22:33:38 GMT -7
Hi Tara, Yes you should ask about the Pepcid AC, even though it seems he is doing fine.. It is better to prevent damage than to cure it after it happens. 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.aspxNot all Veterinarians are experienced and knowledgable about IVDD. It takes 8 weeks for a disc to form secure scar tissue, it takes longer for a disc to heal than a broken bone. Releasing them from crate rest too early can cause an early healing disc to re-tear causing an increase in pain. You saw that happen when your Vet said he didn't need crate rest anymore and he started moving around and yelping. Henry wasn't fully healed yet. One reason some vets may be reluctant to give a full prescription of time is knowing many owners will not follow through. Perhaps not fully understanding the reason for it, is why people tend not to do it. Observation of 1000’s of Dodger dogs over years, has shown a conservative approach to crate-rest time, results in fewer relapses. Dodgers prefers the safer, more conservative recommendations of neuros and other vets using 8 weeks for crate rest. "Strict confinement is crucial and is considered the cornerstone of conservative therapy for IVDD (the dog is kept in the cage at all times and only taken outside to relieve him/herself). In order to accomplish the goals of preventing further extrusion of the nucleus of the disk and to promote healing of the outer layers (the annulus) of the disk, strict confinement is necessary. Activity can easily push more of the nucleus into the spinal canal and dramatically worsen the neurological status. It is not uncommon to see dogs that have “gone down” after a short course of pain relievers given without insuring that the owner would enforce strict cage rest." Dr Larry Carpenter DVM MS ACVS sites.google.com/site/sturgisvet/small-animal-services/faq-s-about-disk-disease Most dogs sleep when their people are away at work or running errands, so that is likely what Henry is doing when you are away. Are you able to give him his medications on schedule during a working day? How about potty breaks? If not do you have a trusted friend or family member that can help out? Reading all you can about IVDD will help you become the expert so that you will know when you are being given the wrong advice by your Vet or anyone else. Dodgerslist helped me so much when my Tyler woke up paralyzed a year ago January.. He's had two episodes one was milder than the first one.. He's doing great now.. You wouldn't even know he has IVDD.. |
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Post by Tara & Henry on Jun 14, 2014 17:26:20 GMT -7
Hi everyone ,
Henry is doing good today he lays in his crate like a champ. I squish his pills in soft treats and takes them with no problem . I do have a question I decided not to give Henry prednisone (personal health reasons ) so will his back still heal just being on Tramadol and Methocarbonal ? My vet dose'nt like to use Prednisone unless nessary . I'm not understanding something how do plan an all day activity when your dog is crated all day ?Do pet owners just put their life on hold until their dog is healed ? I'm so use to Henry being with me when I'm going to be gone all day . Now I have to do things without him is that right ? Thanks so much Tara and Henry
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Post by Tara & Henry on Jun 14, 2014 20:02:53 GMT -7
I was just reading another post and I was wondering if Henry has no pain does he still need to be on the Methocarbonal and Tramadol ? As I mentioned before Henry is not on prednisone . Also how do you plan a day away from home with your doggie being crated all day long ? Or do you plan anything at alll ? How does everyone do it ? Henry and I are still trying to work out all the details of ivdd . Thanks alot Tara and Henry !
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Post by Pauliana on Jun 14, 2014 21:06:40 GMT -7
Hi Tara,
Tramadol is a general pain reliever and Methocarbamol is a muscle spasm reliever. They work to control painful symptoms, they don't cure a disc episode. Prednisone works to relieve inflammation and swelling of the spinal cord. Swelling causes pressure on the spinal cord which can cause nerve damage/paralysis.
Henry needs to be on Prednisone to get the swelling/inflammation down in his spinal cord. Also abruptly stopping Prednisone without a taper is not the thing to do. Prednisone needs to be tapered for health reasons to signal the body to start making it's own steroid hormone. Withdrawing prednisone also needs a large amount of care. The hormone comes under the glucocorticoid class of hormones. Unlike anabolic steroids, it does not build the body, but it helps in breaking up stored fats, sugars and carbohydrates by acting upon the metabolic processes. Abrupt discontinuation of the drug can cause a metabolic crisis.
Adrenal glands naturally produce these hormones, so it is important to keep the adrenal glands active. If the adrenal glands detect external administration of these hormones, they can stop natural production. Over time the adrenal glands decrease in size from lack of use and stop production of the hormone completely. Abrupt discontinuation of prednisone can result in a total absence of the hormone making the body incapable for responding to stress factors.
To keep the adrenal glands active for producing, it is extremely important that prednisone be tapered off slowly. The best way to do it is to put the dog on alternate day dose after the condition has been controlled. The interval can later be increased based on the specific condition that it is being used for.
What to expect during the inflammation/swelling phase of a disc episode
With conservative treatment reduction of swelling can take 7-30 days on a NSAID or a steroid (but never both together) to resolve the pain caused by inflammation. Swelling is best resolved by using the big-gun medications rather than herbs. Glucocorticoid steroids are synthetic versions of the body’s naturally occurring hormone, cortisol. Steroids are basically the most powerful of anti-inflammatories. With IVDD, an anti-inflammatory dose is used rather than a higher immuno-suppressive dose used for other diseases. There are no safe medications. There are two safety factors with drugs. One is a vet who practices safe medicine with a blood test to verify the liver and kidneys are healthy prior to starting the medications. The other is an owner who is well read and educated on what the side effects are and monitors their do
Rule of thumb:
pain = swelling = more time on anti-inflammatory, pain meds and Pepcid AC needed.
The "why" behind the above rule: Often it takes being at the anti-inflammatory dose level anywhere from 7-30 days. When the vet guesses swelling might be gone there will be a test.
If steroids, there must be a taper for health reasons. Usually the first course of a steroid at the anti-inflammatory level will be 5 or 7 days and then a taper. To have a clear picture on a steroid taper, pain meds are also stopped or backed off too. The steroid dose is lowered to less than the anti-flammatory dose. The owner's job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. Immediate feedback to the vet about any pain is necessary. Often a plan B is arranged ahead of time so that if the pain happens at night or on weekends when the vet is not open, the owner knows what meds to give til the vet can be contacted.
Tyler was included in our daily life while in his crate during his recovery. We had a recovery suite in the living room, a crate in the bedroom, and office. In the car we had carrier that was cushioned for him so he could safely travel. We rearranged our lives during his recovery to a certain extent since we are retired. Life was different for a while but I don't regret that for a moment. He recovered very well with the tender loving care he got and he's worth it. We have a lot of working members here too and I know many found ways to get through it with their dogs..
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Post by Tara & Henry on Jun 17, 2014 18:25:17 GMT -7
Hello Everyone,
Wanted to give an update on my Henry . He is doing good on his predinisone,Tramadol and methocarbonal . Henry is not in any pain that I can see . I just make sure he gets plenty of T L C and I talk to him all the time so he does not feel so alone in a crate . I'm Staying positive for Henry .
Everyone have a nice Wednesday ! Tara and Henry
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Post by Tara & Henry on Jul 1, 2014 18:03:20 GMT -7
Hello Everyone ,
Wanted to give an update on my Henry . He is doing very good on confined crate rest . I give him things to occupy his mind . Henry just started his 4th week of crate rest . Question: Does it matter if Henry finishes all his meds before his 8 weeks are completed ? Thanks again Tara and Henry .
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Post by Pauliana on Jul 1, 2014 21:04:40 GMT -7
Hi Tara,
Has Henry completed a Prednisone taper yet? Does he show any signs of pain? Normally a taper is done as a test to see if the swelling in the spinal cord has gone down. The pain medications are stopped at the same time so you are able to see if he shows signs of pain. Shivering, tight hard tummy, reluctance to move and yelping.. If he shows signs of pain, it means the swelling is not yet down and he should go back to the original dose of the Prednisone and the pain medications as soon as you see pain. If he doesn't show any signs of pain on the taper, it means the swelling is down and after completion of the Prednisone taper he would no longer need the medications.. Just continue the crate rest for the rest of the 8 weeks.
I am glad to hear that Henry is doing so well and is at the half way point in his crate rest! Keep up the great care!!
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Post by Tara & Henry on Jul 2, 2014 12:45:46 GMT -7
Henry finsihed his tapering of the prednisone and is not on pain or muscle relaxant .. Henry is not showing any signs of pain . Just the opposite he is alert, wagging tail and wants to play . I don't let him do anything except relax in his crate . Thanks again for all your advice ! Tara and Henry
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Sabrina
Helpful Member 
My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471 
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Post by Sabrina on Jul 3, 2014 20:18:41 GMT -7
Hi Tara, I'm Sabrina. Great news about Henry being off meds and pain free! Have you seen the page on the main Dodger'sList site that overviews the 4 Phases of Healing from a Disc Episode? www.dodgerslist.com/literature/healingpage.htm I've found it to be such a great resource to read and re-read - it's really helped me to wrap my brain around what is actually going on during a disc episode: Medications for = Phase 1: total pain control dose to dose of pain meds, while Phase 2: the anti-inflammatory resolves the swelling/inflammation causing the pain. Time and the Body work to = Phase 3: develop secure scar tissue over the 8wks of 100% strict crate rest to protect the healing disc(s) Phase 4: regain neurological function, which can happen weeks, months, or years later. The great thing is that there is no "expiration date" for healing nerves! www.dodgerslist.com/literature/healingnerves.htmSo keep up the good work with giving Henry the strict crate rest he needs! You are doing the best thing possible for him! ))Hugs!(( |
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