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Post by Remysmom-Amber on Apr 17, 2013 20:39:20 GMT -7
Amber's Remy 4/16 conservative NECK French Bulldog
Hi, I am the mom of three french bulldogs. My youngest, Remy recently apparently had an incident with his spine. We saw nothing happen, just out of the blue screaming, crouching, spasms and trembling in his neck, just horrible. Rushed him to the nearest ER who treated him with Methadone and sent us home with Tramadol, Gabapentin and Rimadyl (sorry if these are misspelled!) That was the night before last, so about 48 hours ago. Nothing seems to be controlling his painful episodes. He goes for a few hours resting in his crate and then all of a sudden it starts again. Hes had about 3 bad episodes that took him a good hour to calm down from after administering more tramadol. Hes also not drinking water and has not gone #2. Hes been eating his food though.
I asked them to please prescribe him a muscle relaxant and they refuse for some reason. They just keep telling me to bring him back in if the meds aren't working and they will hook him up to IV medication. I've been giving him extra Tramadol as needed but I feel like with the spasms in his neck a muscle relaxer would help more. He is an extremely anxious dog, and anxiety seems to be setting them off. I don't feel like he will be able to recover at home until we get his pain under control and they only thing they will do is admit him. Should I try to find someone else? What can I do? Any advice would be appreciated. We saw the hospital's neurologist for about a half hour yesterday, paid 200, and I feel like we have gotten nowhere.
I can't leave the room for a second without him crying and panicking. All three normally follow me from room to room and have major separation issues. I've decided to stop working because of this so I can be home with him 24/7 which is bad enough, but I can't even get the doctors to work with me on a treatment plan.
Thank you very much for any advice at all!
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Post by Pauliana on Apr 17, 2013 21:24:49 GMT -7
Welcome to Dodgerslist, my name is Pauliana, what is your name? Here are some links to finding a IVDD vet in your area. www.acvim.org [neuros] www.acvs.org/AnimalOwners/DiplomateDirectory/ [orthos] It sounds like he is having a cervical neck disc episode and those are extremely painful. Here is a link that gives more detail. www.dodgerslist.com/literature/cervical.htm#painThe best tool for healing short of when surgery is indicated is – Crate rest— 100% STRICT crate rest for 8 weeks. That means 24/7 in the crate except for potty breaks. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no Chiro, no VOM. The rest of the details of doing crate rest: www.dodgerslist.com/literature/cratesupplies.htm www.dodgerslist.com/literature/CrateRRP.htm In order to help Remy, we need to know the dosages of medications he is currently on and how often they are to be given. Please include the all important stomach protector such as Pepcid AC since he is on Rimadyl which is a NSAID. Tramadol and Gabapentin are usually very effective for IVDD pain but often a muscle relaxer needs to be added such as Methocarbamol. Many vets have had wonderful results with those 3 medications. Not sure why your Vet refused to allow a muscle relaxer. PEPCID AC: 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. 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 NSAID. Pepcid is generally considered a safe-over-the-counter suppressor of stomach acid production for a healthy dog and good insurance. 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.html www.dodgerslist.com/neurocorner2/stomachProtection.htm
Constipation:
Meds such as tramadol or post op after-anesthesia can cause constipation. 1 teaspoon of plain pureed canned pumpkin 1 x a day PLUS soaking kibble with equal parts water for all meals can loosen stools. Hint: freeze in teaspoon size portions
to use as needed.To learn more about IVDD please begin your education here. www.dodgerslist.com/healingindex.htm The more you know the better.. so you can advocate for Remy to make sure he gets the care he needs. You are the captain of his health care team and it's important that the vet listens to you and is responsive to what Remy needs.. I know how upsetting and scary it is to have this happen to one of your precious dogs, I went through it with my Tyler although his disc herniation was in his lumbar area. There is hope, you just need a vet that will cooperate with you in setting up the right treatment plan for Remy. |
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Post by christine on Apr 17, 2013 21:24:55 GMT -7
Hi Remy's mom, my name is Christine, what's yours? I'm not a moderator, but they're very attentive and I'm sure they'll be along to reply with more info before long. It sounds like you're do everything just right. Do make sure that he is on 100% STRICT crate rest, only out to potty and back in. Limited movement is the key to recovery. I think your instincts are right that Remy should be on a muscle relaxer, otherwise it sounds like he is on a very typical course of IVDD meds. His pain should be controlled dose to dose. If he's in pain his doses aren't right, yet. Getting his pain under control is priority number one. You should also get a stomach protector on board, Pepcid (famotidine) 30 minutes before the Rimadyl. NSAIDs can cause ulcers and it's best to be cautious now rather than deal with a stomach issue on top of IVDD. Try asking your vet if there is any reason not to give Pepcid. It will be very helpful to know the exact dose of each of Remy's medications. Does Remy have bladder control? Is he able to sniff and pee? Does he have leg movement? If you find that your vet is not cooperative it may be time to look for a vet more comfortable in treating IVDD. If you haven't already, take a look at the readings dodgerslist site, you can start in the disc disease 101 section: www.dodgerslist.com/literature.htmI know how scary it is to face this at first, but you can do this! My Lola is in her 5th week of crate rest and recovering well, but those first few nights were awful. There is hope for all IVDD dogs. Remy sure does look like a cutie in your profile pic. Keep us updated. Christine |
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Post by Remysmom-Amber on Apr 17, 2013 22:03:48 GMT -7
Thanks so much for the response! He was prescribed 50 mg of tramadol every 8 hours initially, but after telling the vet it was not stopping his pain she upped it to 1.5 every 8 hours. This hasn't been enough either. I can't figure out what is causing the "episodes" because they've come on randomly here's my diary of it helps!
First official dose Tuesday 6:30a.m, at1:30 pm he had painful spasms while I was out, my husband gave him another 25mg, when I got home he had another incident but much worse and I gave him another half tablet (25mg) then another after he continued to scream, this was about 2:30pm yesterday
Next dose at 8:30 p.m. last night 50mg
Stayed up to give another pill at 2 a.m. shut the lights out and he had painful spasms about 5 minutes later, gave another half,
then another, didn't calm down till 3, still panting hard at 3:30. Spoke to er vet who said the rimadyl and gabapentin should kick in soon and help they pain.
Today- 1.5 pills at 10 a.m. (75mg)
Fine but restless until 2pm, started twitching cried once or twice, gave him a half, then another half around 2:10-2:15
Tried to be very quiet and calm as he tries to get comfortable, seems to find it difficult to lay down and sleep
2:35 breathing normally, resting, no twitching seen. 3pm seems anxious, panting, maybe because got up to use the bathroom, was crying when I left the room, then seemed upset after I got back.
Slept for a few hours.
Took one 50mg tramadol again 7:30p.m.
Took out to pee around 10, he was very stressed after and had a bad episode of the crouching, spasms, screaming etc. forced him to take 1 pill at about 10 p.m.
Gabapentin 100mg (originally prescribed once per 12 hours- after speaking to Dr last night she changed it to one every 8), first dose was at 6:30am yesterday, then again at 3:30 p.m. yesterday (3 hours early) then again at 12:30 a.m. last night.
Gave him his next pill at 10 a.m. this morning, then again at 6 p.m. tonight. Planning next dose for 2 a.m.or so
rimadyl chewable 25mg every 12 hours with food
Yesterday- 1:30p.m. 1 dose after eating, next dose -10p.m. after dinner (too early, our mistake)
According to Dr he should wait a few extra hours add buffer before being given next dose.
He had next dose today at approx 1:30p.m.
didn't want to eat, had to hand feed him with hot dogs, then ate plenty of food, then gave dose.
Next dose due @1:30 a.m.
after reading some things here I called the doctor about the pepcid which she wouldn't recommend or not recommend. They basically won't tell me anything over the phone. The answer is always, come in our call the neurologist when she's here. I asked if there is a reason I can't and she didn't haveone
. I explained that he had also had hemorrhagic gastroenteritis about two months ago and the last thing I need to add is stomach problems. Last year at some point we had to take him in for another stomach problem, it also seemed like it couldhave
been hemorrhagic gastroenteritis or possibly a blockage that slowly worked itself out.
I'm worried that he hasn't pooped since Monday too. I think I'll try the pepcid tonight after reading what you said. Thanks very much for any thoughts, glad you're having success with your puppy!
Oh and I'm Amber by the way, nice to meet you and EXTREMELY grateful for this site!
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pam
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Post by pam on Apr 17, 2013 22:32:36 GMT -7
So sorry your doggie is going through this! I just wanted to tell you that my dog has a herniated disc in his neck and he was put in hospital at first on the same meds you are using and he was getting worse so they gave him iv meds and it really did not help that much and it actually made him more agitated! They released him home after 6 days and he was still having spasms and pain so I called and they upped all his meds to the max dose for his weight 4 more days and he was still having pain. I finally moved all his meds closer together(half hour apart) I don't know if that really helped but finally after 10 days he started getting better and not having pain!! So don't give up hope they can get better! Demand the muscle relaxer from the vet or find another! My dog is on muscle relaxer,tramadol,gabapentin,pepcid and steroid and strict crate rest! The first week I kept getting him out of the crate to hold him when he was in pain and I believe me jostling him around made it worse,so I left him in there and would just stick my head and arm in to comfort him! Good Luck Pam Oh and try pumpkin for laxative,Nikko hadn't went either I gave him 1tsp and within a half hour he went  |
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Post by Remysmom-Amber on Apr 17, 2013 22:32:43 GMT -7
I'm wondering if anyone might know if the pepcid inhibits the gabapentin? I read that some antacids should be taken two hours apart from gabapentin, but I don't know if pepcid is included in that. He's scheduled to take them both around the same time tonight. I think I will wait to start the pepcid till tomorrow just in case. Tomorrow will be 48 hours on the gabapentin, and I read somewhere it can take that long to help.
I just wish I could figure what is triggering these random "attacks" so I could prevent them.
Thank you Pam that's really helpful info! I'll try to find some print outs or something to give to my vet, I really feel like they would help his muscle spasms and general anxiety. I have diazepam for myself but I'd be terrified to try to give it to him, I know he needs something though. I feel like they would rather have him there and suck as much money as they can than try to help him manage at home. You feel like a monster mentioning money, but if he can rest and recover at home it only makes sense anyway.
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Post by christine on Apr 17, 2013 23:29:18 GMT -7
Amber, I'm sorry Remy is having such a hard time. Many people find acupuncture and laser light therapy very helpful in managing the pain of IVDD. You can begin those treatments during crate rest (as long as you can transport Remy in a crate). You can look for a holistic vet in your area here: www.ahvma.org/My vet had given me permission to give the tramadol every 6 hours instead of 8 for the first couple of days, that might be something to consider if the pain persists. I know neck episodes can be very painful. I hope you can both get some sleep tonight. |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 18, 2013 9:24:46 GMT -7
Amber, if the pain is not yet under control, then you will need to find a vet who is willing to help control pain. If pain were being aggressively treated (which it is not yet being done) by dose, dose frequency and mixture of pain meds and yet pain will not be brought under control, then there is a serious consideration about surgery. Lots of good info here: www.dodgerslist.com/literature/healingsurgery.htmNote the anti-acids spoken about that need a 2 hours space are those with magnesium or aluminum. Pepicid AC has neither. It is given every 12 hoursMethocarbamol (Brand name Robaxin) is a staple with a disc episode. Tramadol is a general pain reliever, but methocarbamol specifically deals with the pain stemming from muscles spasms so often associated with a disc episode. Make sure you are following all the extra things one can do for a neck disc in the link Pauliani gave you. www.dodgerslist.com/literature/cervical.htmLet us know you do have Pepcid AC on board right now and what the new vet says and prescribes to get pain under control. |
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Post by Remysmom-Amber on Apr 20, 2013 9:51:44 GMT -7
We took Remy to new neurologist on Weds 4/18. He was WONDERFUL, took so much time with us and was sympathetic and kind. So glad we decided to give someone else a shot. He insisted that the muscle relaxer would not help him at all but said we could try it as long as we plan to get him the MRI if we see no improvement soon. I burst into tears as soon as he said that-such a relief to be able to try whatever we can to help him here at home. Since then Remy has shown huge improvement. He seemed to have a small episode of pain while finishing up at the vet on the 18th. He'd been standing for an hour and we gave him a tramadol while there, I think it kicked in just in time for the pain to calm down before getting into a full blown hour long episode. He's only had the methocarbamol one time on the evening of the 18th. He seemed uncomfortable so we thought we'd try it out before he went to sleep for the night. The new vet prescribed us one weeks worth, 1/2 tab 3x day. The bottle says 500mg, #15. So I'm not sure what the half tab actually is. Since he hasn't had any true episodes of pain and muscle spasms I'm being conservative with adding more drugs. I'm thinking that the anti inflammatory must be kicking in or something. We've started staggering the tramadol and gabapentin so we're trying not to give them both at once. Shooting for one every four hours. We haven't gotten on a real schedule at this point just taking it day by day making sure he's comfortable at all times. Trying not to give him too much or too little. They also upped the dosage of ▲ Rimadyl from 25 mg to 35mg every twelve hours with food. They said the pepcid wasn't necessary if he's eating a full meal with it and he's only pooped twice since the incident but it's been very healthy (thank God) so I'm a little on the fence about adding something else. I want to avoid problems but don't want to add problems. Thanks all again for your help, it's been a stressful week here with Remy's back, the Boston bombings, quitting my job and then the insane manhunt yesterday. We're just south of Boston, my husband works there, friends live there, it's just been a crazy crazy week! Hopeful it's all up from here! Thanks again so so much for your advice, we've felt so alone and helpless since this happened and this site has been our only source of advice and information. |
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Post by Nancy & Polly on Apr 20, 2013 10:52:07 GMT -7
From what I've read, Pepcid is benign as far as your worrying about adding another "med.". It's only function is to protect the stomach. The results of not using it can be dire, so to me it seems like a no brainer. Our dogs had never had any issues with their stomachs on NSAIDS before, but it's cheap insurance with no downside or side effect.
Pain is a nasty thing. Don't back off the pain meds too soon. There is no virtue in taking less, if it allows pain break through.
Our hearts are with all of you in the Boston area!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 20, 2013 10:53:10 GMT -7
We see too many vets who are not proactive in protection of the stomach lining and dogs suddenly vomiting, diareah or worse. You will have to do your own research and decide if you wish to be proactive too by following the same vets Dodgerslist follows...those who prescribe Pepcid AC. 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. Pepcid is generally considered a safe-over-the-counter suppressor of stomach acid production for a healthy dog and good insurance. Did you ask ... Is there a medical/health reason for my dog not to take Pepcid? "The use of a GI tract protectant in cases that are receiving NSAID's or steroids would definitely be warranted under the supervision of the patient's veterinarian." Dr. Andrew Isaacs, DVM Diplomate ACVIM (Neurology) Dogwood Veterinary Referral Center www.dodgerslist.com/neurocorner2/stomachProtection.htmIt is important to realize that subclinical gastroduodenal ulceration is likely to be present in dogs with type 1 disk extrusions, even without the administration of potential ulcerogenic drugs (e.g., NSAIDs, glucocorticoids), so the use of such drugs should be minimized if at all possible. Curtis W. Dewey, DVM, ACVIM Neurology Cornell University.A Practical Guide to Canine and Feline Neurology 2nd ed Blackwell Publshing 2008 pp331-33. Chapt 10 "Myelopathies: disorders of the Spinal Cord"; By Curtis W. Dewey pp331-332 "Famotidine is useful in any situation where stomach irritation is an issue and ulceration is a concern. "www.marvistavet.com/html/famotidine.htmlLet us know that pain is now being fully covered dose to dose of his pain meds. Is below now the correct list, dose and frequency you give? If pain is not being covered with this now aggressive approach to pain control, then surgery would be a serious consideration as this new neuro has told you. Glad you went for a second opinion!!! |
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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 Apr 20, 2013 19:22:01 GMT -7
That is wonderful news that Remy has his pain under control. Good for you in getting another opinion - you are a great advocate for your dog! Keep us posted on his progress Keeping you in thought and prayer. |
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Post by Remysmom-Amber on Apr 23, 2013 13:47:05 GMT -7
Hi, unfortunately Remy seems to have had a set back. He went for a full two days with no episodes at all, then Sunday out of nowhere he had a full blown attack at 4 p.m.. then again last night. I'm so frustrated because I can't figure out what is triggering these episodes, especially after going for so long with nothing happening!
The only two things I can think of....the two days he went episode free, I was here at home with him by myself, very little stress. Then the past two days my husband was home so I took the opportunity to do some things around they house, nothing that seemed to trigger anything obviously, but I'm just grasping at straws really. He is naturally a very very very high strung anxious dog.
The other thing was that I added memory foam to his crate on Friday night, Saturday he was fine, but then Sunday and Monday he was clearly uncomfortable. I'm wondering if the foam is having the opposite effect.
I'm so frustrated because I feel like something is causing the episodes but I can't figure out what. I have kept track of every pill he's had since then and I could add it if it could help. We have no schedule that has worked do we just keep tweaking it, trying to give more often and higher doses without overdosing him. Ugh, my poor baby.
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Post by Nancy & Polly on Apr 23, 2013 16:43:19 GMT -7
Can you call the neuro for some advice?
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Post by northwoodsdoglover on Apr 23, 2013 20:43:17 GMT -7
Hi Amber -
My doxie, Max, had a cervical disc issue and suffered several setbacks in the last 2 months. Things would look positive, and then he'd be back to a pain episode. I don't really think there is anything that is "causing" this or anything that you are doing that is causing him to regress - my vet told me that if they just move their heads a little bit the wrong way, it can trigger more pain. It seemed for Max that when he was feeling a little better, he would sit up a little and try to look around, then back we'd go! We had about a week where he was feeling better, then at one potty break he decided to suddenly shake out his body and we were back to practically square one!
But take heart - it will take time but I bet that Remy will pull through this. It took Max almost 6 weeks to get off anti-inflammatories (prednisone in his case) but he is now doing MUCH better and we are nearly ready to graduate from crate rest. Call your vet and make sure he/she knows what is going on... but be prepared to be patient. It's hard, but keep your cool when he's going through some pain. Since he is so bonded to you, he will pick up on your calm presence and that will help him calm himself, too.
<3
Teresa
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Post by Remysmom-Amber on Apr 24, 2013 7:29:03 GMT -7
Thanks for the advice, I'm going to have to call the neurologist today.
(He is taking the methocarbamol now also
Yesterday went great, I decided that I think the gabapentin is helping more than I thought it was before and started giving that every 5-6 hours instead of eight. I also switched him over to an ex pen and got rid of the foam. He seemed much more comfortable and had no episodes.
However, he started having loose stool and last night has BLOOD in it. So I'm just so frustrated at this point. The vet insisted the pepcid was pointless if he was taking the Rimadyl on a full stomach which he has. Probably one time he had it an hour after eating a large meal. Otherwise it's just after.
Can anyone tell me what happens now? I gave him a pepcid last night, and I'll give him a pepcid before eating lunch today but I just thought I'd try to find out anything I can before calling the neurologist.
I've only given him the pepcid a few times because I've been paranoid it might interfere with one of the other meds he's taking. I've been looking for some kind of pattern. It's been a guessing game every day off what helps and what doesn't. It really sucks that you have to choose who to believe with a sick dog! A website or your 200$ a pop neurologist. And the neurologist keeps being wrong. It's really pathetic. I can't imagine what the hell happens now, another drug?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 24, 2013 7:47:11 GMT -7
Amber, you have a dangerous situation now. Get on the phone and tell the vet of the blood. Do not take no for an answer...get sucralfate on board. This med works in a different way than Pepcid AC to bandaid the damaged areas of the stomach lining. Pepcid is still needed as it works to reduce stomach acids. Is the blood red or black? Do your own reading on how to time Pepcid AC, sucralfate, feeding times at this vet web page: www.marvistavet.com/html/sucralfate.htmlSince you just indicated Remy has been on methocarbamol since 4/20 it may be time to think about surgery. Is that a consideration for your family? |
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Post by natureluva on Apr 24, 2013 7:55:28 GMT -7
Hi Amber, I am in Plymouth, MA. The blood in the stool means there is an internal bleed, likely due to his stomach being UNPROTECTED from the excess acid produced by the Rimadyl. Please call the vet ASAP and ask them for Sucralfate, and tell them that you want to give the Pepcid. Tell them he has bloody stools. Next, if you need recommendations for vets in our area, here are mine: My recommendations for Massachusetts IVDD vets: For Neurosurgeons/Ortho Surgeons: Angell Memorial: www.mspca.org/vet-services/angell-boston/neurology/ and Dr. Henry and Dr. Briere: www.bostonvetspecialists.com/specialists.html For a holistic vet acupuncturist, who also happens to be a Board Certified neurologist: Dr. Mark Russo: www.kingstonah.com/site/view/105296_AcupunctureHolisticMedicine.pml He is in Kingston, MA. Keep in mind, when cervical IVDD pain cannot be well-controlled with meds, surgery may be necessary. Have your specialists work TOGETHER to come up with a treatment plan for Remy. Please let us know that you have called about his internal bleeding. Best wishes, ~Lisa |
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Post by Pauliana on Apr 24, 2013 7:59:13 GMT -7
Amber,
The Pepcid doesn't interfere with his medications, antacids such as tums and similar WOULD interfere. When my Tyler had his disc rupture we took him to Purdue University Vet Teaching Hospital. The Neurologist there included Pepcid in his medications that he went home with. She said IVDD dogs are prone to stomach problems and the NSAIDS make it even worse. Purdue is up on all the latest treatments.. They brought Tyler through surgery and he is is running around here after his crate rest graduation a month ago, like nothing ever happened.
Now that Remy has blood in his stool his stomach issues have turned serious. Please take him to a Vet that is comfortable treating IVDD correctly. He now needs to be on Sucralfate to heal his stomach.. Rimadyl is notorius
for causing Ulcers and stomach bleeds. That's why we harp on making Pepcid part of the treatment plan..
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Post by Remysmom-Amber on Apr 25, 2013 12:50:14 GMT -7
Hi everybody, thanks for the replies! Ok, so the blood in his stool was red, and just a few drops. Since Tuesday night he has still had a bit of diarrhea but it is the usual color and has no blood.
The neurologist said I should look out for dark tar like stool. I'm confused about what the different issues are really with Rimadyl. I guess liver damage is shown by the dark blood, but I don't know if an ulcer is dark blood too. I read that red blood signifies lower intestine. He said colitis is a side effect from all the meds but to take Remy off the Rimadyl to be on the safe side. He didn't mention the sulcrafate.
I also gave Remy an anti diarrhea medicine yesterday afternoon that I ordered recently from Amazon. It's called pro-pectalin gel he had one bout of diarrhea after that but then hasn't gone #2 since. I also have him pepcid the night after I saw the blood and twice yesterday.
I'm feeling really confused about how long I should give this conservative treatment time to work. When the neurologist saw him for the first time last week he said he would have a 50/50 shot of healing without surgery with pain management and strict crate rest. He said if within a month he has shown no improvement we should get the mri and most likely the surgery.
When I told him what was going on he said he doesn't think Remy will be able to heal on his own and that if he hasn't been able to manage the pain at this point he probably won't be able to at all.
I keep reading different things that people say it can take a long time to get the meds right and the pain under control. I don't know how long I should go. For the past two days again, he's had no major episodes. I can tell his neck is sensitive when he yawns, shakes, or barks, he'll twitch or hunch. I feel like when we give the meds every 3-4 hours it keeps him very comfortable. But it's like as soon as he is uncomfortable the pain comes on so fast that it's hard to get the meds into him before he is feeling obvious pain.
After the two days of no episodes, the stupid water company came pounding on our door to get us to move our car and he barked and had a small episode. The meds seemed to kick in fast though and he didn't go into a major pain attack.
So now without the anti inflammatory I'm obviously more concerned about him healingon his own. I ordered Vetri-disc which i had over nighted and I'm hoping will replace the Rimadyl. Also thinking of trying the serrapeptase which I've read is a great natural anti inflammatory and dead tissue dissolver which has no effect on the stomach. You actually take it without food, which I'm not sure how I could work with a dog....
As far as the surgery the vet told me we would be looking at 8,000. We paid 200$ to see the first neurologist and another 200$ to see the second. I called Angel and we're looking at another 235$ or so to see a third neurologist and I have no guarantee of any difference in the protocol. Plus we're over an hour away.
I'm at a loss frankly. I'm literally just taking this minute by minute trying to keep him medicated and comfortable. It's breaking my heart. All I did was lay in bed and cry yesterday. I haven't left his side since this happened.
Due to his two recent incidents of stomach trouble before the disc thing ever happened, we've already spent a good 2 grand on vet bills. We have pet insurance and I think they pay maybe 600 toward the surgery (I haven't found out the specifics, just skimmed their info on disc disease online, we've never even used the insurance before, even though we have tons of claims to file, they don't put a time limit on filing and I've just been avoiding it for some reason, they make it really confusing)
Obviously if he needs the surgery to live pain free, he'll get the surgery, but spending ten thousand dollars on his care in a year will basically ruin us. Sooooo, I really don't know what the hell to do at this very moment.
Thanks for all your thoughts and ideas, I appreciate it more than I can say.
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Post by Remysmom-Amber on Apr 25, 2013 14:15:23 GMT -7
I just noticed the link for the acupuncturist in Kingston, thank you. I just got off the phone with the vet trying to find out what the procedure would be if we wanted to go ahead with the mri. I guess they would do a chest x Ray, abdominal ultrasound and then the mri if everything came back ok. Then straight to surgery the same day so they don't have to put him under twice.
I'm surprised it would all happen at once like that. I thought if he got the mri we would be able to have at least some time to figure out how to proceed.
I'm waiting for the vet to call me back with a breakdown of costs at which point I'm going to call VPI to get a better understanding of their coverage.
Right now I feel like I can't go more than 3.5 hours without giving him a gabapentin and a tramadol. I don't know if I should continue the frequent dosing to manage the pain, or what. The neurologist said upping the gabapentin quite a bit wouldn't kill him (although there's always a chance with any drug obviously) but that he didn't think it would work.
According to what I've read online, the dose for gabapentin for PAIN is 1.4 mg per pound every 24 hours. Remy is 32 pounds, which should mean 45mg once a day should be the dosage. The vet initially prescribed 100mg twice a day, then upped it to 3 x day.
BUT the dosage for treating seizures was something like 4-13 mg per pound every 8 hours. Or for him, 128mg-400mg 3 x day.
So obviously the vet wasn't going by either of these dosing recommendations, seems like somewhere in between. I just don't get it.....
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Apr 26, 2013 9:31:00 GMT -7
I'm sorry to hear that Remy is having a tough time with pain. IF, if you can keep the pain under control, then you might be able to avoid surgery and give the disc time to heal. HOWEVER, without Rimadyl on board, this is really going to be very tough as there is are not the big gun anti-inflammatories needed to address getting swelling/inflammation down. The bleeding/diarrhea was due to the stomach and the rest of the GI tract not being protected. Red blood is lower down in the intestines bleeding, black black is bleeding in the sotmach where it got digested and turned black. Pro-pectaline is for non-life threatening forms of diarrhea. Bleeding GI tract problems are life threatening..so Remy needs to have his stomach protected and protected well. Again, I can't emphasize enough the stomach and GI tract has to be protected… Pepcid AC alone is enough for most dogs (however you were not even giving it!) When there is bleeding then sucralfate is brought in to work in a different way to actually bandaid the damaged areas and help them heal. Remy never had a chance at good stomach protection. Pain ought to be in control within one hour with the right combo of meds on board, the right dose and the right frequency. Methocarbamol for the pain from muscle spasms If you are using the max of meds, dose and frequency and the pain still shows up nearing the next dose, then it would be time to seriously consider surgery. Veterinary anesthesia Support group Individual Pain med Drug summary www.VASG.org/individual_drug_summaries.htmVetri-disc is not going to be an anti-inflamamtory… in fact it is not likely to do anything for a disc problem. Do your own homework so you will have an understanding of why: www.dodgerslist.com/literature/Supplements.htm If there is to be surgery, only and MRI would be chosen, as a planning tool for the procedure itself and then quickly go into surgery. An MRI or xray or ultrasound would be used to rule out other maladies that could mimic a disc problem which may change the diagnosis and the treatment. I know you have a difficult decision on whether to do surgery or not or try to be a bit more aggressive with pain meds. You might discuss actually getting aggressive on stomach protection, if that would allow bringing Rimadyl back on board with some degree of safety. Do let us all know what the vet says. We are here to support you with your decision. |
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Post by Remysmom-Amber on Apr 26, 2013 11:23:59 GMT -7
Thanks for your reply. We brought Remy in for the MRI this morning. They are going to do a chest x Ray first and said since he is a young dog the abdominal ultrasound wasn't really necessary. They mostly do that for older dogs with health issues....So they will do the surgery today also if the mri confirms what they think it is. I think they said it was called a ventral slot. They would expect him to be there for five days. So now I'm just waiting to hear, trying to not indulge in a crying fit, but I feel like puking. Yesterday and last night the pain just wouldn't stop and its been ripping my heart out seeing him in pain.
He had no bowel movements yesterday and then today he had a nice healthy one before we left for the vet. No diarrhea. I feel ok with the stomach situation at this point. I don't know if I over reacted to the blood. It was three in the morning, raining, and I could barely even see it. Maybe it was just a funky color. I really don't know because when I checked for it the next day it had washed away in the rain.
They mentioned putting him on Rimadyl after the surgery (assuming he gets it) and I said I don't want to mess around with that drug. I guess I'll wait to cross that bridge when we get to it. They know I took him off of it and why. There's got to be some other option....!
The reason I started the vetri disc was because it was recommended in a natural dog healing book I have. I know that most things don't cross the blood brain barrier, I read the page on supplements on the website here. I figured that adding it in might help him heal faster, it has several ingredients besides the usual glucosamine etc and I don't know if any of them could help. I figured it would be worth a shot.
So that's it. I guess if he will be getting the surgery I have a lot more reading to do....
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 26, 2013 11:48:49 GMT -7
We are all anxious to learn about the surgery results. I'm sorry the pain could not be controlled….the same happened with my little girl and we did the neck surgery. The next day she was being walking pain free at potty time. I hope to hear the same good news for Remy.
Sending our most positive of thoughts for Remy. Since Remy has had a history of stomach problems, I would advocate for good stomach protection. Just like people get stressed and produce extra stomach acids, Remy too has been under stress with all the pain he's been dealing with. Then if Rimadyl, a NSAID, would be added he really needs stomach protection to be proactive against having more problems. Just something to keep in mind to discuss with the surgeon.
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Post by Remysmom-Amber on Apr 26, 2013 11:53:14 GMT -7
So the neurologist just called and said the mri showed a very large herniation between discs c2 & c3 so they're taking him into surgery now. He said it's textbook with frenchies. I know he does this kind off surgery all the time so that's a comfort.
I just can't wait to hear that it's over and he's ok. Definitely think I'm going to let myself cry for a while now....
Thanks Paula, that's nice to hear. You say she had the surgery on her neck and was walking the next day? That's great. He's a sensitive little guy but he bounces back fast. I hope he recovers as quickly! He's only 4.
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Post by Pauliana on Apr 26, 2013 12:30:39 GMT -7
Amber, sending hugs to you and prayers for Remy. He's in good hands with an experienced surgeon who has done many of these surgeries. While my Tyler had a lumbar herniation, he had lost the use of his back legs, when he woke up from surgery he was moving his back legs and the next day he was walking.. I hope the surgery gives Remy the same outcome and most of all relief from pain..
Have a good cry and then be hopeful for great news when the phone call comes.
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Post by Linda Stowe on Apr 26, 2013 13:50:24 GMT -7
We're all thinking of you and Remy now. While cervical can be more painful treated the conservative route, there is usually very good results with the surgery.
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Post by Remysmom-Amber on Apr 29, 2013 7:13:24 GMT -7
Thanks you guys for the positive thoughts! Remy was supposed to spend five days in the hospital. We dropped him off Friday morning and just got a call he's ready to come home early so I'm scrambling to find out if you experienced ivdd pros have any recommendations for what I should ask.
I guess he is very stressed being there and won't eat but they don't want to sedate him. He's only taking Tramadol at this point and they've weaned him off iv drugs. They said he is doing great, walking on his own and peeing outside. They want him to start oral Rimadyl tomorrow and think he should eat at home when he is less stressed.
Now I'm stressed! Lol I'm really scared to bring him home so soon. He's been there exactly 72 hours basically. Is this typical? After the "blood/red stuff/who the heck knows" in stool we found that one night the Rimadyl spooked me. Is there something we should ask him to take with it besides the pepcid? When I asked the surgeon he said he thought he was taking it before the surgery, and I was like.....uh yeah, remember the blood thing took him off, he got worse, now he's here? It's like every time I mention it, they don't seem to remember, or tell me I should talk to the surgeon, but the surgeon didn't even remember. I don't get it. I don't know why they want to get rid of him so fast? They said he's resting comfortably and not in pain (so they don't want to sedate him) but gets excited when someone comes in. I don't feel very comfortable with this practice as four people told me not to give him pepcid. Yesterday when I got his progress report over the phone the woman I spoke to was really rude when I dared to question the Rimadyl. It's like if I ask a question or mention something I've read they get so insulted. They all keep telling me not to believe what I read online. (This is always my experience with every Dr.I've met anyway!) I asked her to explain the mechanism of action of other optional nsaids and she asked me if I was a doctor. I'm just so frustrated with these people but they have my baby so I have to be nice but they're so difficult....
They want to send him home on tramadol 3x day 50mg and Rimadyl 2x day. Any thoughts at all?!!?
Thank you so very much!
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Post by Pauliana on Apr 29, 2013 7:35:08 GMT -7
Hi Amber! Relieved to hear Remy is doing so well after surgery. My Tyler had surgery on Monday and Purdue sent him home on Wednesday because he was doing so well. Not unusual if a dog is responding well after surgery. They actually heal better at home in familiar surroundings. Many vets tell their clients not to believe what is on the internet. This Vet is not familiar with the success cases on Dodgerslist or with the Neuro Vets that advise us. Please read this link and tell them about Dr Isaacs and what he has to say. www.dodgerslist.com/neurocorner.htmAlso tell them world renowned Purdue University Veterinary Teaching hospital follows Dodgerslist protocol. In fact when Linda, our founder, started Dodgerslist, Purdue was so impressed they offered her a tour of their facility.. That was 11 years ago. It's time they become educated. Give them the link to our website and they can see for themselves. www.dodgerslist.com Pepcid AC as well as Sucralfate to protect Remy's tummy. He has had issues before, it is vital to protect his stomach while on Rimadyl. Old fashioned vets wait until after you find blood in the stool, we believe in Vets that are proactive to prevent a problem before it develops. Remy will be so excited to get home.. Take a deep breath and know everything is going to be ok.. You are Remy's advocate it's up to you to be firm on what you want to protect Remy. You are paying them to do the right thing. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 29, 2013 18:54:09 GMT -7
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