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Post by Cal & Boner on Jun 26, 2014 19:45:25 GMT -7
Hi everyone, Boner has been going through his 3rd disc episode for the last two weeks. His 1st being in April of 2013 and the second being in March of this year. dodgerslist.boards.net/thread/1505/cals-3-4-conservative-neck?page=3 As you can read in the above posts, he completed his crate rest in May and seemed fine for about a month. During that month I still kept his mobility limited just to be on the safe side. However, he had a flare up again a couple of weeks ago. He has been on his usual combo of Rimadyl, pain meds, and crate rest for the last two weeks. During the first week of Rimadyl he had laser therapy also and seemed to be doing well. We then tried to take him off Rimadyl after one week, hoping that we would not have to keep him on it another week. However, he started shaking again so my vet immediately put him back on Rimadyl. He also had another round of laser therapy. During this second week, his pain has been harder to control and I have been in and out of the vet. He is currently on the highest doses of Tramadol, Gabapentin, and Robaxin for his weight. I have noticed slight shaking (not nearly as bad as it was) only every once in a while for the past few days. My vet has said that we may have reached a point where he needs to go to either the University of Florida Animal Clinic or the Auburn University Animal clinic (I am in Panama City, FL). He told me that surgery may not be necessary since he has no neuro problems, but that they might be able to find a way to manage his pain better. Any thoughts on this... Any advice on these two clinics...? I am familiar with both cities as well as the universities...I have also been reading up on them as well and am undecided on which one I would choose to take him to if needed. He is ending his second round of Rimadyl on Saturday- if he gets in pain again, I am preparing for the possibility of having to take him to one or the other in the next week or two. Also, any feedback on a situation like this where surgery may not be necessary but pain management is becoming more and more of a problem...enough to where I have to go out of town to treat it...? Thank you all so much in advance. PS. Boner's disc problem is located toward the very end of his spine- my vet mentioned that, usually, disc problems are located more in the center of the back...just thought I would add in that info. UPDATE: Since I wrote the above, Boner had about 1/2 an hour of very noticable shaking/trembling. He then fell into a deep sleep for a couple of hours and was very relaxed. He woke up and has been shaking again, though not as bad. I am going to call my vet as soon as they open-like I said, he is on the full dose of pain meds and has been on Rimadyl for 2 weeks. Should I consider giving him some more time on the Rimadyl before making the decision to go to Auburn or UF- or is 2 weeks on Rimadyl and all of the pain meds long enough to wait? |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,586
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Post by PaulaM on Jun 27, 2014 7:51:03 GMT -7
Cal so sorry to hear about another disc episode. If you will give us the full details on the current meds we'll be better able to comment. 14.5 lbs Rimadyl ?mg ?x/day started June 13th ish?Tramadol ?mg ?x/day Gabapentin ?mg ?x/day Robaxin ?mg ?x/day Pepcid AC 5mg 2x a day  ?The body's ability with the help of an anti-inflammatory to resolve all the painful swelling can range from 7 to 30 days. During that time pain meds must be able to mask the pain. If, indeed, Boner is on the high end of pain meds and yet the pain will not be kept at bay, then if may well be time to consider surgery. Both Florida U and Auburn U are excellent to get a consultation from and discuss whether surgery at this point should be considered. |
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Post by Cal & Boner on Jun 27, 2014 9:40:28 GMT -7
MEDS:
Rimadyl 25 mg once daily
Famotidine 5mg twice daily
Tramadol 50 mg every 6 hours
Gababpentin 70 mg every 8 hours
Robaxin 250 mg every 8 hours
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,586
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Post by PaulaM on Jun 27, 2014 9:53:06 GMT -7
The meds are at the aggressive range. So I agree, it is time to seek the opinion of a specialist about surgery at one of the Universities. If the pain can't be fully controlled, then he can't comfortable heal his disc under conservative treatment. So in Boner's case the surgery would not be to prevent worsening neuro functions, but to remove the pieces of disc material that are causing the pain. With conservative treatment the hope is with time the disc material will be reabsorbed enough to no longer cause pain as the pain meds give time for that to happen.
A half hour of shaking is alot of pain. Normally dogs won't want to show any signs of pain. So by the time we see them showing pain, it must hurt very much.
Let us know how the neuro consultation goes. We'll have Boner in our thoughts til we hear back from you.
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Post by Cal & Boner on Jun 28, 2014 14:32:44 GMT -7
Boner has been better the last day with no signs of pain- he is on his 17th day of Rimadyl and pain meds as listed above. My vet has put him on an additional 10 days of Rimadyl with the continued pain meds. We are going to see how he is doing on Mon/Tue of this week and then decide whether or not to do a consult at the University of Florida.
Should I be concerned about keeping Boner on Rimadyl and pain meds for such a long time- the most he was on all of this in the past was 2 weeks. I am also concerned about the high doses of pain meds he is having to be on for so long. Have any of you had experience with keeping your dog on these meds for almost a month? Boner's blood work as of April was good, so my vet says he should be ok- but I wanted to get your feedback as well.
Thank you.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,586
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Post by PaulaM on Jun 29, 2014 11:21:17 GMT -7
Cal, that is good new that pain has been brought under control. If the pain can stay in control then he can continue to do two things under conservative treatment.....get the swelling down in the spinal cord with the aid of Rimadyl. Each dog is individual on how long it takes to resolve the swelling.... ranges form 7-30 days and even we have had a few dogs on this Forum that took over 30 days. Having had the blood test is an excellent practice that vets who use meds safely do. Making sure YOU are up on all the adverse side effects to monitor for is the 2nd safety factor for Boner. With NSAIDs side effects can happen unexpectedly even when taking the right dose. So do read up on what to watch for: www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm196295.htmThe 2nd thing Boner will be doing under conservative treatment is getting the disc to heal and make good secure scar tissue for the remainder of the 8 weeks. The pain meds are short acting in exiting the body that is why you give them every 8 hours and will very likely not to cause a problem. We got our fingers cross the pain meds will continue to keep pain fully at bay.... do keep us all posted. |
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Post by Cal & Boner on Jun 29, 2014 22:16:51 GMT -7
Boner has been shaking some again tonight. As I mentioned, this is his 3rd disc episode, but I have never seen the shaking come and go the way it has been this time. Yesterday he was relaxed and comfortable all day.
I am going to be speaking with my vet tomorrow about the possibility of doing a neuro consult at UF. Here is my question: I know they typically do not want to do surgery until absolutely necessary- but wouldn't it be better for me to go ahead and at least do a neuro consult BEFORE it worsens...but on the flip side it is a 5 hour trip to UF from where I live and transporting in and out of a hotel, so that concerns me as far as moving him around a lot while on crate rest...
Any advice on this...Have any of you had surgery on your dog's back before it became absolutely necessary to do so...or done a consult just to see where your dog stands in terms of treatment? This disc flare up has come only 1 month after his previous one...does this likely mean surgery is going to be inevitable at some point? I want to do everything I can and am scared of waiting, especially with him having a flare up so soon after his last one...I would rather be proactive.
Just as added info to help with responses, I would be able to pay for his surgery if it is needed.
Thank you.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jun 30, 2014 4:25:39 GMT -7
I'm sorry to hear that you're once again seeing signs of pain, Cal. Yes, it's always a good idea to have a neuro specialist do an exam. So you have a better idea of when surgery should be a consideration, please take a look at this page: www.dodgerslist.com/literature/healingsurgery.htmA neuro consult doesn't always lead to surgery. It may be that a switch to a steroid is medically necessary to address the swelling that is causing the pain. If so, please be sure to discuss with the neurologist adding Sucralfate along with the Pepcid AC to double protect Boner as there should be a 4-7 day washout period when switching from the NSAID to a steroid. Once the swelling is brought down, the damaged disc will no longer be pressing on the spine, which is causing the pain. The fact that Boner has had another disc episode only one month after his previous one doesn't necessarily mean that surgery is inevitable. However, if Boner has been having disc problems in the same area of the spine each time, it may be the same disc, so then surgery would be indicated. I definitely do think that a neuro consult is in order at this time. Just be sure to pad Boner's crate very well during transport in the car and in and out of the hotel so he doesn't jostle around too much in the crate. If he gets excitable during car trips, you might want to ask the vet for a mild sedative to calm him. Healing prayers for Boner. |
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sneha8upta
New Member
Who is smarter? A dog or a cat...
Posts: 1
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Post by sneha8upta on Jun 30, 2014 5:26:37 GMT -7
So sad to hear from you and feeling sorry that we can't do anything except oral consolation. Take care...
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Post by Cal & Boner on Jul 5, 2014 23:01:07 GMT -7
Hello everyone, Boner has his neuro app. scheduled for this Wednesday. He had 3 more laser treatments for the past 3 days (which makes 9 for him total). Since Friday, I have not seen any signs of pain. He has been on Rimadyl and his pain meds for almost one month now, and as mentioned above, we have had a really hard time trying to get his pain under control, which is why I scheduled the neuro app. Now I am wondering if I should cancel his neuro app. since he seems to be pain free- but I am worried that maybe the pain relief is just temporary because he just had the laser treatments over the past few days. The neuro app. is 5 hours away and will require a hotel stay- so I don't want to put him through that trip for nothing... would it be wise to go ahead and keep the neuro app. even if he remains pain free? My thinking is that at least that way he can be evaluated and be better treated in the future...I need to make a decision by Monday so I wanted to get your advice. I'm obviously worried about canceling it and then having him return to being in pain...I'm at a loss....please help  |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
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Post by Marjorie on Jul 6, 2014 6:33:10 GMT -7
If I recall, the main reason for the neuro consult was because Boner's pain could not be brought under control. I believe your vet also felt that they might be able to find a better way to control his pain. Now that his pain is under control (and I'm so glad to hear it!), a neuro consult isn't necessary at this point. If you took him in now, you would just be bringing in a dog with no neuro deficits whose pain is under control with no need for a neurologist to adjust his meds. It seems that the meds, along with the laser treatments, have done a good job of controlling his pain. It's been a little over three weeks since he's been on the meds. In another couple of weeks, I would speak to the vet about testing for pain - stopping all meds to see if pain returns. It usually takes 7-30 days for the swelling to resolve. If there is no return of pain upon the stopping of all meds, that would mean that the swelling is gone and there is no longer any need for meds. If the pain returns, then a longer period of meds would be needed. Pain = swelling = more time on all meds. Keep up the good work! |
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