Julie's Frankie now 5/22 surgery NECK

Medicine Dosage and Schedule

5:00 A.M.
Pepcid AC
Tramadol 50 mg, 1/4 a tablet
Prednisone  5mg, 1/2 tablet (for 5 days, then every other day)
Methocarbamol 500 mg 1/4 tablet

3:00 P.M.
Tramadol, 1/4 tablet
Methocarbamol, 1/4 tablet

9:00-9:30 P.M.
Tramadol, 1/4 tablet

Hi Julie,

I am so sorry Frankie is having a rough time.   Dogs often hide their symptoms at the vet and that really can complicate things at times.

The fact that he is yelping at home, can be fear of pain but it could also be true pain. In the crate he isn't moving as much, when out of the crate he may be moving in such a way that the pain hits him suddenly.

Keep watching him for signs of pain since the lowering of the dosage of Tramadol. If he continues to yelp, call and tell the Vet and ask for an adjustment to his pain medications so he is pain free. Did the Vet recommend surgery during the appt? Or was he just preparing you for the possibility?

Hi there, many times, the nerve pain medication works very well at eliminating pain when given in combination with Tramadol. You may wish to ask your vet if gabapentin may be an option for Frankie.

Frankie could be feeding off of your fears. If he senses anxiety in you, he will also be anxious. Anxiety combined with pain can cause any dog to lose his personality. Try to put a smile on your face and in your voice when you are with Frankie. His reluctance to move may be because he is in pain. If this is true, please ask your vet about the gabapentin or even a stronger opiate pain reliever.

Is surgery a financial option for you? If so, it would be wise to have Frankie evaluated by a Board Certified neurologist. It is always a good idea to get a specialist's opinion. The neurologist will want to view the x-rays your vet took, so bring those films with you or have your vet send them to the neurologist before the appointment.

If finances are an issue, consider applying for Care Credit. They offer no interest or low interest financing for veterinary costs. You can apply online and be approved the same day! Here’s the link: www.carecredit.com/faqs.html. Here are two links to help you locate a Board Certified neurosurgeon (ACVIM) or orthopedic surgeon (ACVS): www.acvim.org/websites/acvim/index.php?p=3# and www.acvs.org/AnimalOwners/DiplomateDirectory/.

Links for possible financial assistance:
www.thepetfund.com/
www.uan.org/index.cfm?navid=163 www.humanesociety.org/animals/resources/tips/trouble_affording_veterinary_care.html
www.help-a-pet.org/
www.speakingforspot.com/helppayingforveterinarycare.html
www.theamericandogmag.com/non-profit/resources-veterinary-bills-financial-assistance

Walmart, Target, and many grocery stores have a generic drug program and you can get a 30-day supply of some drugs for $4 each. Walmart has TraMadol in the correct dosage for our dogs and also Prednisone. Target may have Methocarbamol. So, you can ask the vet for a prescription and take it to the store and have it filled. Just tell them it is for a K9. Here is a Generic Med List: genericmedlist.com/

Hang in there, do all you can to make sure Frankie's pain gets under control. Your vet has an arsenal of pain meds at his disposal. Talk to your vet about adding gabapentin or replacing Tramadol with a stronger opiate pain med. Also schedule an evaluation with a Board Certified neurologist if it is within your budget.

We look forward to your next post. Best wishes, ~Lisa

During the time on the anti-inflammatory the pain meds do need to be adjusted so that there is no pain surfacing dose to dose of pain relief medications. Pain deters healing.

Often it takes being at the anti-inflamamtory dose of prednisone (5mg 2x/day) for 1-2 weeks or even for some dogs more like a month before all the swelling is gone. On the taper the dose is lowered to less than the anti-flammatory dose and that is the time to assess just how well reduction of swelling is going by observing for pain.

Rule of thumb is:   pain = swelling = more time on Pred needed.

Sooooo…… from what I gather his pain meds are reduced and he is tapering pred:
1. May 19, Tramadol was reduced to 1/4 tablet 3x a day.  That likely is the reason for the pain 
2. And it looks like prednisone  at 2.5 mg is being giving 1x a day… it is being tapered.

Because Frankie yelps, that is a clear indication that not all the swelling in the spinal cord is gone.  If you are going to proceed with conservative treatment, then you need to discuss with the vet about  staying on the anti-inflammatory dose a bit longer AND having the pain meds at the dose and frequency to keep pain fully away.

Pain is something to be VERY concerned with. Herniated discs, damaged spinal cord require a significant amount of time to heal. New tissue must be generated. Swelling must have time to subside. Pain is so important to the overall well-being of a patient that it has become the 5th cardinal sign of human assessment. (Philips DM. JCAHO pain management standards are unveiled. J.Am Med Association 284(4):428-429, 2000) Institutions can risk their federal funding if they do not routinely assess for pain.  We should demand no less for our dogs.

If the  pain meds are correctly prescribed there should not be good and bad days.  If the pain can't be controlled with max doses of pain meds and after being on the anti-inflammatory level of pred (which may take several courses) then you should get a consult with a board certified surgeon re: surgery.  But so far your vet is not aggressive on pain meds nor staying the course at the anti-inflammatory dose of Pred.  You will need to take the lead as Frankie's health care team captain.  If your vet is not comfortable in treating a disc episode then you may well need a 2nd opinion from another general vet or from a specialist.

YOu wrote he put Frankie back on methocarbamol AND lowered Tramadol. It really sounds like your vet is not comfortable in using the meds that keep pain away. As you read others posts, these three drugs may be used together (methocarbamol, tramadol and gabapentin)

I'm glad you are staying on top of things. So you know all the options…ask what range in mg dose and frequency you may give each med. Hopefully you will find the combo, the dose in mg and the frequency that keeps Franklie comfortable.

Have you discussed going back to the original anti-inflammatory dose of Pred for a bit longer.

Julie, kudos to you for speaking up!!! This disease requires us owners to understand how healing happens, what the meds are for and when they should be stopped and when they need to be used a bit longer. You applied what you learned on behalf of Frankie!

It is difficult when you have to be the "expert." It would make a world of difference if you could locate a vet who is comfortable in treating a disc episode. Until then the burden is on you to monitor, speak up when things don't seem right and discuss everything with the vet, not the vet tech, not the receptionist. Ask what is his thinking behind everything so you know, compare to what you have learned here and then make your own decision because you are the captain of Frankie's health care team no longer blindly following instructions. All things IVDD are laid out for your self-education program. Do explore each of the topics here: www.dodgerslist.com/healingindex.htm

We like to think every doctor, every vet knows all diseases, but of course this is not true. How often do we go for a 2nd opinion when our doctors are not helping us? And our doctors only deal with one species…the human one. Our vets on the other hand see many species...cats, reptiles, birds, hampsters, and all breeds of dogs. On top of that they must be pediatricians for puppies, be dentists for dogs, practice surgery and know their internal medicine. Are you surprised it is difficult to keep current on every disease for every species? There are IVDD knowledgeable vets out there…you will just have to find one. This article can help you think through it. www.dodgerslist.com/literature/VetchkList.htm  What is your city/state?

Hi Julie, Go here www.acvs.org/AnimalOwners/DiplomateDirectory/ and put in Missouri and there are some ortho specialists in the St Louis area. Both orthos and neuros are good at surgery.

Julie, Here is a neuro in Manchester that one of my friends in St Louis just recommended. www.vssstl.com/ourteam.html He said Dr. Wininger was very good.

My significant other, Blair, took Frankie to see Dr. Wininger today.

When they arrived, Dr. Wininger was in surgery, and Frankie was first seen by an ER/critical care vet.  She performed an examination and said that Frankie's pain is cervical, not lumbar.  Dr. Wininger shares her opinion.  He recommended an MRI and surgery, if necessary, since we have been trying to medically manage Frankie's pain for about three weeks without resounding success.

Frankie is staying overnight at the clinic where he will receive intravenous pain meds to make him more comfortable. 

I hope the MRI does not reveal lumbar and cervical degeneration. 

Thank you for the support and stellar recommendation.

Feeling hopeful now that we've finally got Frankie under the care of this neurologist, who described himself as a dachshund doctor because most of his patients are dachshunds (and he has a dachshund at home). 

Sad to come home to no Frankie : (

Good for you for seeking the best of care for Frankie! Sending healing thoughts your way!

I am so glad that you were able to get Frankie to an expert - good for you for not giving up and pushing for what he needs! Keeping you in thought and prayer:)

It is likely that he would have eaten at home in his own environment but probably more important that he's in a place where they can care for his back than that he miss one meal. I don't mean that as harsh as it may appear in print, just trying to help you prioritize Frankie's needs at the moment. If you already had him there then leaving him meant one less trip in the car thus less opportunity to jar his back and potentially cause further damage.

I know this is hard. It's hard when you can't see them. It's hard when you can't touch them. You always feel you can give them all the best care. I've been there so I totally understand that need to see with your eyes. But the decision to leave him though emotionally difficult was in his best interest. So cudos to you for being a good dog owner!

As a rule vet clinics have flexible schedules with tests and surgeries. If a dog appears uncomfortble or condition is worsening but was scheduled for later in the day then the schedule is adjusted to move him ahead of a dog that seems more stable. It frustrates us owners as we don't get firm times on when our dog will get his treatment but it's beneficial to all in the end.

Take some deep breaths, hang in there and keep us posted.

Frankie is out of surgery. I know very little because the surgeon had another surgery to perform. He sounded pleased and said it went very well. He promised to call back later to give me an update.

So glad he had a successful surgery. Sending positive thoughts for healing!