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Post by Whitney & Charlie on Feb 4, 2017 17:12:12 GMT -7
Whitney's Charlie 2/4 true conservative treatment I wasnt sure where or what to post, so here's the back story...We're close to Dallas, Tx USA. Our 3 year old dachshund, Charlie, started showing signs of pain around 1/14, some limping and occasionally yelping when we picked him up. We thought he might have slipped in the backyard chasing a squirrel/rat and might have hurt his leg. (We just moved into a new house and the previous owners left us a ton of leaves in the back yard, coupled with some rain we've had, we thought he slipped on some wet leaves chasing something.) I took the dogs to the vet on 1/16 for nail trims and had the vet look at his leg. She did a physical exam and thought it might just be a pulled muscle, gave us some Deramaxx [1/16] and said to come back in a week or so if it wasnt getting any better. Of course, we ended up back in the vet's office the next weekend for a second check. Charlie wouldnt cooperate so the vet could check to make sure there wasnt a torn tendon, so she sent us home with more Deramaxx and Tramadol, and told us to come back in a few days if he wasnt improving to sedate him so they could do some x-rays.
We took him in on friday, 2/3, and he was sedated and x-rayed. Follow-up this morning and he's got some serious back issues and a couple of bone spurs. The last two vertebrae are showing signs of calcification and there's some issues with the discs further up - no specific mention of herniation, slipped disc, IVDD etc, but she did mention potentially referring him to a specialist for surgery if we wanted. We're starting him on another drug on Monday that she says he's perfect candidate for - I didnt catch the name or the type of drug, but it's something he can take long term that's not an NSAID. ☆ 1 Which breed? What is your dog's name? Your name?Our Charlie is a 3 year old Dachshund, we're in Dallas, Tx USA☆ 2We dont have an IVDD diagnosis yet - our vet is a general practice DVM☆ 3 What was the date you saw the vet and started 100% STRICT crate rest 24/7 for 8 weeks?We've seen the vet on 3 occasions, 1/16, 1/30 & 2/3. We initially ☆ 4 He's still in some pain, much less now that he's on the Tramadol. He walks fine on 3 legs, but when he wants to pick up the pace he will sometimes "tripod it" down the hallway if we're moving around. Otherwise he's content to stay in his cave bed, even when we take our other dog outside. Since adding the tramadol, he's been a little more playful lately, but really only from the comfort of a dog bed or pillow.☆ 5 How much does your dog weigh? 12.6#☆ 6 Please list the exact names of meds currently given, the start date, their doses in mgs and how often you give.[12 lbs]Deramaxx 25mgs tab as of 1/6: - 12.5 mgs 2x/day for 21 days (1/2 tablet at a time) started 1/16Tramadol 50mg-17mgs 2x/day (1/3 tablet at a time) (we were giving the OK to up the dosing on this to 3-5x a day if he needs it) ☆ 7 He can walk and move all of his legs, tho he will sometimes "tripod it" and not put weight on his back right leg (the one we thought initially had a pulled muscle/torn tendon)☆ 8 He can but he is not interested in going outside as much. He is pee pad trained and will use that every now and then. Only one "accident" so far - this morning when we were on our way to the vet and that was probably out of excitement/scared.☆ 9 Eating and drinking OK? Poops OK - normal color no dark or bright red blood?Not very interested in food but will eat most of his food at mealtimes. We are noticing that he is having trouble pooping, physically getting into that position hurts his back, no other problems noticed there. The vet recommended canned pumpkin or Metamucil added to his food to make it a little easier for him to go which I will start adding to his food tonight. |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,814
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Post by PaulaM on Feb 4, 2017 19:36:35 GMT -7
Whitney, welcome to Dodgerslist, we are glad you are here. Do know anytime there is a suspicion of a disc involved, the prudent thing to do is 100% STRICT rest 24/7 for the full 8 weeks, only out for a very, very few footsteps at potty time. If this is intervertebral DISC disease and it sounds like it is, then the way a bad disc heals with with limited movement. This video show the tragedy if the disc would worsen because of too much movement causing severe damage to the spinal cord PAIN Charlie IS in pain because the meds are not right. Can you get ER help if your vet is not available to night or in the morning. Monday is a long way off to have to needlessly suffer with pain DRUGS It is extremely important for you to be knowledgeable about each med your dog is on. What is the name of the new med to be used on Monday? This vet's drug directory is how I stay informed about my dog's meds, I think yo will want to bookmark it, too: www.marvistavet.com/pharmacy-center.pmlPlease give us the details on his meds with number of mgs for each dose and how often you give it 12 lbs Deramaxx as of 1/16: ? mgs in one dose 2x/day to stop on date?
Tramadol 17mgs 3-5x/day Pepcid AC should be on board. Charlie is already showing red flag signs! Stress, change in routines and NSAIDs all cause extra stomach acids. Pepcid AC suppresses the extra stomach acids that anti-inflammatory drugs cause.  So we follow the vets who are proactive in preventing nausea, not eating, vomit, diarrhea, bloody stool, bleeding ulcers from progressing to life threatening perforated stomach lining. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours and giving the anti-inflammatory with a meal for added protection. Get Pepcid AC at the grocery store but FIRST do ask your vet in this particular way: Is there any health reason (heart, liver, or kidney) my dog may not take Pepcid AC (famotidine)? Know all about your pet's meds, reading IS an important safety factor: www.1800petmeds.com/Famotidine-prod11171.html and marvistavet.com/famotidine.pmlCRATE REST how to's ☐ Let us know you are on the same page about the importance of crate rest. Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm PLUS further guidance on conservative treatment on our "All Things IVDD page: www.dodgerslist.com/healingindex.htmSTRICT means: - no laps - no couches - no walking down the hallway - no baths - no sleeping with you - no sleeping outside of a recovery suite - no chiro therapy - no or meandering at potty times. Using a pee pad right outside his recovery suite, is a good idea to limit those footsteps to the very, very fewest. GETTING UP TO SPEED It won't take much to bone up on your dog's disease to care for him now and know how to live many happy years ahead with IVDD. Keep in mind the name of this disease is intervertebral DISC disease. So it is all about getting the disc to heal. www.dodgerslist.com/healingindex.htm would be a great place to start your IVDD education. Do check out the "Conservative Treatment" yellow button first so you get a quick handle on all the phases of healing that take place during conservative treatment. Then when you have time in the next days do explore all the other buttons to be the IVDD savvy pet parent your dog will be depending on. |
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Post by Whitney & Charlie on Feb 4, 2017 22:30:41 GMT -7
Charlie will be off of Deramaxx after tomorrow morning - he has 1/2 a tablet left. The tablets were 25mg each, halved makes them 12.5mg. And we have access to an emergency vet if we can't get in touch eifh our vet.
We will ask about Pepcid when we pick up the other medication. He has been resting more comfortably since starting the tramadol [on date?] and doesn't have any trouble getting comfortable when he lays down.
I added pumpkin to his dinner tonight and he ate all but a bite or two of his dinner, so his appetite is definitely improving. He has always been a finicky eater regardless of the type of food. .
My husband found the "little back bracer" and plan on asking the vet about that as well. Wondering if anyone else has used one and had any successes or issues with one?
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Post by Pauliana on Feb 4, 2017 22:55:53 GMT -7
Glad to have you here Whitney!
Orthotics such as a back brace should require an Rx from a board certified neurologist (ACVIM) who is well educated in disc disease. An ill fitting product that is not custom made can do more harm and the Rx would be for a specific reason.
Dodgerslist has consulted with several neuro and rehab specialists. The overriding concern is that owners may buy a brace on their own thinking it will be instead of strict crate rest or think it would prevent a future disc problem.
During a disc episode these are the concerns:
- Getting them on without causing any more pain or damage to the spine is on top of the list. Too much movement to get the brace on is not good for a dog that you are trying to limit movement of the back.
- Additional muscle atrophy in the spine is another big concern as muscle strength is very important to maintaining spinal health.
- Unnecessary discomfort, pain and anxiety caused by having to wear this device tight enough to limit movement… adequate limited movement is supplied with owner commitment to safe and effective 100% STRICT crate rest 24/7.
- Braces would require monitoring for pressure (rub) sores. Also, if not properly fitted (not covering from thoracic down to tail) there is the potential to create a fulcrum. It is hard to immobilize the entire back and not end up creating a fulcrum that stresses out adjacent disks.
- A brace would not be a preventative measure. Disc disease is the cause of prematurely aging discs…a disc problem happens at the point the disc has hardened too much. Any activity such as turning to lick a paw or putting on and off a brace could be the last straw for a disc that is no longer flexible.
At this time there isn’t enough research on them for Dodgerslist to support their use with an IVDD dog. What we do know is that strict crate rest is what works to heal a disc – it’s proven and crate rest is safe.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,814
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Post by PaulaM on Feb 6, 2017 8:40:15 GMT -7
Whitney, it is very concerning that Charlie has been on Deramaxx for 21 days now and yet not on the single most important care of 100% STRICT rest inside of a recovery suite. Limited movement prevents damage to the disc scar tissue trying to form. When there is damage there continues to be pain and a great potential for the spinal cord to be damaged by the bad disc. Is Charlie now inside of a recovery suite, no longer allowed to walk down a hallway? What kind of recovery suite did you choose for Charlie: wire crate, expen, packNplay.... The true way to test for pain to see if Deramaxx need to continue is to stop the pain masking pain meds. HOWEVER you still report there is pain even with Tramadol and Deramaxx on board. Resting more comfortably is not good enough, he should be fully resting in comfort. So with pain still existing, it would not be time to do a test for pain stop of Deramaxx. Your vet needs to know you have not been doing crate rest, and likely the 21 days of Deramaxx have been wasted. True crate rest (inside of of suite, and limited number of foot steps alllowed for potty time) should have started on Feb 4. The count for 8 weeks of time for the disc to heal would then start from Feb 4. 1. Let us know that your vet takes a blood test to test if it is safe to continue on with Deramaxx. OR what is the name of the new drug to use on Monday, Feb 6? 2. What date was tramadol prescribed? Which are you actually giving Tramadol 17mgs 2 or 3 or 5 x/day? There is much more a vet could do to provide full pain relief than the minimal Tramadol currently Rx'd. Big pain requires big pain treatment. A disc episode is a very painful thing. The best pain control during a disc episode, as in people, comes with multimodal pain management: using more than one approach that addresses pain from multiple fronts. Have no patience with any pain. This page will help you to advocate for the usual pain meds used www.dodgerslist.com/literature/healingpain.htm3. All anti-inflammatory drugs NSAIDs or steroids means the stomach needs protection. Is Pepcid AC on board yet? 4. Changing from Deramaxx to a new med on Monday is of concern whether a washout is needed before the start of a new one. It will be up to you to do some homework to be prepared to discuss if a washout is needed. Please do take a momenet to ready all about how anti-inflammatory drugs are used with a disc episdode including when a washout is required: www.dodgerslist.com/literature/healingsweling.htm |
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Post by Whitney & Charlie on Feb 7, 2017 9:48:59 GMT -7
Charlie does not appear to be in any pain, he is wanting to play with his toys and go outside and his appetite is back.
He started Galliprant this morning - 10mg once a day. The tramadol is a 50mg pill split into thirds, so he gets 17mg at a time, once in the morning and once at night with food. Vet said Pepcid was not necessary but we can add it.
[12 lbs
Deramaxx 25mgs tab as of 1/6: - 12.5 mgs 2x/day for ? days STOPPED 2/5
Galliprant 10 mgs 1x/day for ? day NSAID starated 2/7
Tramadol 50mg-17mgs 2x/day]
We are carrying him to and from the back yard to potty.
We are needing some ideas for a mobile of set-up that we can use at night/weekends when we're home to keep him near us. I understand the importance of crate rest, but I don't want him to get antsy if he's crated and we're home but in a different part of the house.
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Post by Julie & Perry on Feb 7, 2017 9:52:32 GMT -7
What I did was set up a pack and play in the living room and the bedroom.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,814
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Post by PaulaM on Feb 7, 2017 9:53:33 GMT -7
EMERGENCY.... was there a 4-7 day washout from the NSAID Deramaxx? No, there was not. Since there was only a 2 day washout, Charlie is under double jeopardy to his stomach lining. Please call right now to get an Rx of sucralfate phoned in to nearest pharmacy. Pepcid AC should have been on board with the start of Deramaxx and now it certainly MUST be on board with this danger switch without a washout to another NSAID! Charlie needs TWO stomach protectors on board soonest possible today! The first step in drug safety is a vet who uses them in a safe manner. Reading about each of your dog's meds is a the 2nd measure of safety. Being able to advocate means having the power to do so. KNowledge is the power. Sucralfate: marvistavet.com/sucralfate.pml there is a timing to using sucralfate with food and with the another brand of NSAID (GAlliprant) Pepcid AC marvistavet.com/famotidine.pmlWASHOUT authorities 1.■ The manufacturer of Galliprant: "Concomitant use of Galliprant with other anti-inflammatory drugs, such as COX-inhibiting NSAIDs or corticosteroids, should be avoided." www.elanco.us/galliprant/vet/2.■ The primary cause of adverse effects from NSAIDs is incorrect dosing (eg, concurrent use with corticosteroids or another NSAID, changing NSAID without a suitable washout).(8 Washout period (dogs, 5–7 days (2 2. Guidelines for safe and effective use of NSAIDs in dogs. Lascelles BD, McFarland JM, Swann H. Vet Ther 6:237-251, 2005.
8. Systematic review of nonsteroidal antiinflammatory drug-induced adverse effects in dogs. Monteiro-Steagall BP Steagall PV, Lascelles BD. JVIM 27:1011-1019, 2013. 3.■ It is also unacceptable to concurrently administer steroidal and nonsteroidal anti-inflammtory drugs (NSAIDs) to disc disease patients, as this combination increases the chances of severe gastrointestinal complications. Curtis W. Dewey, DVM, ACVIM Neurology Cornell University. A Practical Guide to Canine and Feline Neurology 2nd ed Blackwell Publshing 2008 Chapt 10 "Myelopathies: disorders of the Spinal Cord"; By Curtis W. Dewey p331-332. |
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Post by Whitney & Charlie on Feb 9, 2017 15:37:49 GMT -7
We took Charlie off the Galliprant to give his system a break and will resume [Galliprant] over the weekend. No changes otherwise. A friend donated us their old pack and play, and he has taken to it better than I thought he would.... slept in it all night with no issues or whining.
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Post by Romy & Frankie on Feb 9, 2017 16:16:37 GMT -7
I am glad that Charlie is doing well with his pack and play. Crate rest is the most important part of the treatment and it is so much easier if we can keep our dogs near us.
Am I correct in saying that currently Charlie is not taking any anti-inflammatory right now?
Can you tell us if he showing any signs of pain? What kind of stomach protection is on board? It would be just terrible if Charlie developed serious stomach issues in addition to his disk problems.
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Post by Whitney & Charlie on Feb 10, 2017 7:37:11 GMT -7
He has been off of the Deramaxx since Sunday morning 2/5, when he took the last does we had, so almost 5 days with no anti-inflammatory.
He's been on Tramadol and Metamucil/pumpkin since 1/27. We backed off to giving him 1 dosage per day to see how he's doing pain wise and he seems to be doing ok. We can try taking him off if it completely for the next few days and see how he does. We have not added anything and aren't seeing any gastric symptoms.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,814
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Post by PaulaM on Feb 10, 2017 8:53:26 GMT -7
Whitney, let us know what the full stop of Tramadol reveals about pain. Tramadol 1x/day is already like not giving it at all. So the expectation would be you should not see any pain surfacing by completely stopping it.. Let us know, though, what you actually observe.
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Post by Whitney & Charlie on Feb 15, 2017 17:36:53 GMT -7
I need some help with the dosing on the Pepcid. We have 10mg tablets and Charlie weighs about 12 pounds.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,814
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Post by PaulaM on Feb 15, 2017 19:34:18 GMT -7
The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours and giving the anti-inflammatory with a meal for added protection. www.1800petmeds.com/Famotidine-prod11171.html So for a 12 lbs dog that would be Pepcid AC 5mgs 2x/day. Since he is off of Deramaxx, there would not be a reason to give a med to suppress stomach acids (Pepcid AC). Is he back on Dermaxx? Did you stop Tramdol? If he is off all meds now, what is the status of pain. No pain would mean no need of any meds. Pain surfacing would mean the need to get back on all meds for a bit longer to make sure all the painful spinal cord swelling gets resolved. |
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Post by Whitney & Charlie on Feb 16, 2017 15:49:23 GMT -7
He has been off Deramaxx for almost 2 weeks now and off of tramadol for almost a week now. He appears to be having pain/discomfort with his knee - because he is frequently licking that area. His X-rays showed bone spurs in his knee and back, which is why I'm assuming he's licking that area so much. We wanted to try him on the Galliprant since that is a osteoarthritis drug to see if that helped with the bone spurs.
Otherwise, he seems to be back to his normal self. He appetite is back and he'd really like to be out and about. No wincing nor yelping anymore, either
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Post by Romy & Frankie on Feb 16, 2017 16:23:51 GMT -7
Good news that Charlie is not having any more pain from spinal cord swelling. All that remains is the rest of the 8 weeks of crate rest to heal the disk.
The Galliprant may help the knee. Even though it is for arthritis it could help bone spurs.
Watch that the licking does not become excessive. If so you may need to try an e-collar to keep him from hurting himself.
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Vita & Emmie
Helpful Member 
Currently graduated for the 3rd time; walking and running!
Posts: 189
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Post by Vita & Emmie on Feb 22, 2017 10:45:56 GMT -7
Hi Whitney! How is Charlie doing with his crate rest? Is he being a good boy in the pack and play?
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