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Post by Shannon & Beans on Jul 15, 2014 6:54:42 GMT -7
Hello,
I am Shannon Dobson, a canine rehabilitation professional with a couple of questions on the neck suite on behalf of a client. She has an older Dachshund (8-10?) with acute IVD extrusion. Her veterinarian has put the dog on Prednisone and Tramadol but pain is not fully controlled. The veterinarian did NOT recommend crate rest and is only suggesting that surgery may be the only option to control pain (which it may be, we'll see). Neurologic function is all normal. I am offering insight on crate rest to the client and have read all the tips I was able to find. Does anyone have additional tips for the recovery suite other than those I list below?
*feed soft food or moistened dry to eliminate excess crunching
*place crate higher up (on coffee table) so pet can see what is going on without looking up
*place water and food bowls attached to wire at head level - no bending to eat or drink
*pet is 24/7 in the crate for 8 weeks other than potty times
*provide a snuggle warmer to keep heat on the neck
Anyone who has recovered neck ruptures with additional tips? Most of the IVDD I deal with is usually lumbar or thoraco-lumbar junction so I have only recovered a few neck dogs (and none as painful as this one is).
Thank you in advance for any additional tips for my client!
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Jul 15, 2014 9:33:08 GMT -7
Shannon, welcome to Dodgerslist. What good service you are doing for your client and Dexter! The pain meds are not yet right. Tramadol has such a short half life of 1.7 hours that if not Rx'd at minimum of every 8 hours it is not likely to control pain. Most vets include methocarbamol too right off the bat to address the type of pain stemming from muscle contraction pain so often associated with neck discs. Read more about pain control, meds as healing can't get fully under way until 100% pain control. www.dodgerslist.com/literature/healingpain.htmAny time Pred is in use the stomach needs to be protected. 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. We ask that all members read about each med their dog is on or may take as a safety measure. This directory very good for learning about each of your dog's meds: www.marvistavet.com/html/pharmacy_center.htmA Snuggle Safe would be to let the dog lean against if they want to rather than us putting anything at all on the neck. Avoid any chew type toys. Her vet does not seem to be comfortable in treating a disc episode especially the more painful neck ones. If he is not open to being aggressive with pain control, it would be time to hire a new IVDD knowledgable vet: www.dodgerslist.com/literature/VetchkList.htmIs it possible for your client to join us on the Forum? Conservative treatment does take a good support system as often owners don't see important clues we pick up on right away. There is no reason for a dog to suffer with pain while waiting 8 weeks of 100% STRICT crate rest 24/7 only out at potty times. |
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Post by Shannon & Beans on Jul 16, 2014 9:59:06 GMT -7
I have given her all of your information (I provide this to every client) but she is a bit overwhelmed right now with her own personal medical issues and this is part of the issue why I posted for her.
She did have the pet on Tramadol 3x daily unfortunately it caused some fairly serious agitation and anxiety so it was reduced. I contacted the vet personally and we discussed the case, he is an orthopedic surgeon and really feels the pet has calcified disc material already in the neck which must be removed for recovery. Having said that he has worked very well with me to start alternative therapies and pain control measures.
I understand the importance of the pain control completely and have made it very clear to my client that healing is absolutely dependent on pain control. I have referred her to a pain management specialist in our area that I have personally used on a number of occasions. I just wanted to make sure we were doing all we could with the environment itself. We do use the snuggle safe as an option for the pet to set his head against - we are not putting it on the neck (at least, that is how I advised the client to use it).
Thank you for providing a very valuable service to your visitors. I visit this site often, even though I work as a rehabilitation professional, I feel there is ALWAYS something to learn here and I appreciate all of the good information for myself and for my clients.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jul 16, 2014 11:56:05 GMT -7
Gabapentin can be used if Tramadol caused agitation. Also Methocarbamol works on the muscle spasms that are so common with neck issues. Seeing calcified discs on an x-ray is common for dogs with IVDD so I'm not sure what the surgeon means. He may have meant that the disc material that ruptured is pressing on the nerves of the neck. That is what a disc rupture is and surgery can remove that disc material. However, it's the hope with conservative care that the body will reabsorb the damaged disc. If pain cannot be controlled with the use of AGGRESSIVE pain meds, then surgery would be a consideration. Neck injuries can be much more painful than back injuries and we often see aggressive dosages of all three pain meds used in conjunction with each other for neck injuries - Tramadol, Gabapentin and Methocarbamol. Please be sure your client starts Dexter on Pepcid AC as Paula recommended. Here's our page on cervical disc issues: www.dodgerslist.com/literature/cervical.htmHere is more information on calcified discs: www.dodgerslist.com/literature/CalcifiedDiscs.htmAnd here is information concerning when surgery should be a consideration: www.dodgerslist.com/literature/healingsurgery.htmI hope the pain management vet will be able to get Dexter's pain under control quickly. If your client can afford it, acupuncture and/or laser light therapy can be helpful in controlling pain. Please keep us updated. And blessings to you for helping out your client like this!  |
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Post by Shannon & Beans on Jul 17, 2014 6:39:39 GMT -7
I'm doing the laser therapy now but it has been less successful than it normally is (I think due in part to the fact that I was not brought into this until 8 weeks post injury - a VERY long time) and I have recommended the stomach protectant. Thank you for all of the information!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Jul 17, 2014 8:32:15 GMT -7
Shannon, this ortho doesn't understand the significance of crate rest in allowing the disc to heal, so sorry to hear Dexter was not Rx'd the single most important treatment of 100% STRICT rest 24/7 at the get go in mid June. With good rest and aggressive use of pain meds Dexter may be able to avoid a surgery if the pain can be fully controlled. We've got our fingers crossed he will. Can you tell us the the exact dose of current Prednisone and tramadol? How much Dexter weighs? We look forward to learning what the pain management specialist Rx's and what he may sub out with the Tramadol since Dexter is having problems with it. Do you have our phamplet on "Crate Rest Recovery Process" that ortho may find it an aid in helping a future client and your client may like it since she is not able to join us here. Just ask Linda to send you a packet of our literature: www.dodgerslist.com/literature/litorder.htm Would you consider helping another with a recommendation to your pain management specialist for our directory: dodgerslist.boards.net/board/10/guidelines-posting vet recommendations: Name of Vet Name of Clinic Street Address City: State or country: Type of vet (general/board certified surgeon, acupuncture, etc.) Comments: |
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Post by Shannon & Beans on Jul 18, 2014 6:47:04 GMT -7
I do have all of your pamphlets - every disc dog I see, their owner gets a pamphlet and business card because I think it is so important for them to have support. I will try to update as soon as possible with the info you requested. As of 2 days ago my Beagle has had a back episode (he has recurrent back problems due to a non-disc related congenital narrowing of the spinal canal)so I have that to deal with right now.
Ah - such is life.
Will report on Dexter and the pain specialist as soon as possible.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Jul 18, 2014 9:31:30 GMT -7
Hugs to your Beagle. Thank you for helping to educate all!
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