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Post by Carolyn & Buckeye on May 11, 2017 11:35:45 GMT -7
Hello. I am very grateful to have found this forum. My name is Carolyn, and my 12 year old beagle Buckeye was diagnosed with IVDD. Buckeye, a normally super energetic dog with a very bouncy and fun personality, had trouble jumping into our bed on Monday night (5/8/17). He had been playing and acting normally all day. I had a new throw blanket on the bed, and I thought maybe it was just that he couldn't get a good grip to jump up, so, not thinking any further about it, I moved the blanket and stupidly allowed him to jump up again. Once again he didn't clear the jump, so I picked him up to put him in the bed, and he yelped and curled up, then quickly jumped down and laid under our bed. This was about 11PM. Not knowing Anything about IVDD at that time, or really back problems in dogs, I kept checking on him in the night, and then just laid with him on our living room floor until morning to make sure he was ok. He was still walking around from time to time but I could tell he was upset and not feeling good and he kept wanting to lay by himself. I called the vet first thing in the AM when the office opened, and explained what happened. They said to come in that afternoon. The Dr. did a physical examination on 5/9 and said Buckeye had degenerative disk disease, and said it was common in beagles, and observed bulging disk or abnormality at I believe the 3/4 region. He said surgery was the best option at this point, as we unfortunately cannot afford that, we elected to move forward with the conservative treatment. We are being strict with the crate rest, he only comes out to go to the potty, and I carry him out to a grass spot and try to keep him from walking too much, although he really needs a few extra steps to be able to produce a BM so it has been an unfortunate compromise each time he has to do more than urinate. The vet is a general practice DVM but they also do minor surgeries etc there. I don't think he is having pain but it is hard to tell. When he was obviously in pain (before he started meds), he panted and acted very nervous, yelped etc, and he is really not doing any of that. However- he doesn't want to come out of the cage to go out to potty and he has given a slight yelp or whimper some times when I pick him up to do that, even though I try to be extremely careful. I try to limit the times I am taking him out to potty as a result. I usually do potty breaks at about the same time as his medicines, so I am going to try and switch that so I'm never cutting it close to the time that 1 pain pill ending. Buckeye weighs 19 pounds, and has always been on the slim/muscular side for a beagle. His medicines: Tramadol 50mg X 100 Tramadol 50mg X 100- PAIN MEDICATION- Give 1 tablet 3 times daily until his next exam (Monday 5/15)Prednisone 5mg- Give 1 tablet twice daily for 5 days, then 1 tablet once daily in the morning for 10 days, then reduce to 1 tablet every other day until gone [19 lbs Prednisone as of 5/9: 5mgs 2x/day for 5 days, then taper below anti-inflammatory dose Tramadol 50 mgs 3x/day]
He can walk, sometimes with a wobble in his back left leg, and he sometimes drags the tip of that leg/paw a bit, but not always. It reminds me of someone whose leg is sort of falling asleep and then gains control, because usually once he starts stepping with that paw it is still slightly a wobble but mostly normal steps, considering. He wags his tail when we go outside. He is less prone to wag when he is just in his crate, but sometimes he does if I try to give him treats or cheese, happy talk to him, etc. he will. Just not always. He can sniff and squat to release urine and seems to be aware of how full his bladder is. This morning I noticed he had a weaker stream but a large volume and he seemed to empty his bladder, although it took some more time. He is eating and drinking ok-ish. He is actually a lifelong pretty picky eater, and he is prone to not eat or drink if he is not feeling well in the slightest, or for example if we are gone to vacation, he often doesn't eat and drink much when we are away, etc. His moods and overall wellbeing seem to really dramatically impact his appetite. However, I believe the prednisone is helping because he is actually drinking and eating probably to the level of what I would consider normal for a healthy dog. But he is not crazy overeating or overdrinking like I have heard a lot of them do on a steroid, I feel the steroid just gave him a more regular appetite. The first day, 5/8, for example, he would refuse to eat or drink Anything that day, then when I gave him the medicine, he ate and drank a little that night in his crate, and it has improved slowly from there. I am supplementing his dry food with an additional can of dog food for dinner and he usually eats all of that too. I also give him cheese and he eats that too. BMs seem to be ok. He was constipated on Tuesday (5/9), since he hadn't drank enough Monday, and so his first BM was very dry and hard for him to move out. The next one seemed to be normal (firm but didnt look dry, light-medium brown), although it seems like he is struggling a bit to go-he stumbles a bit as he tries to walk and go at the same time. I am so consumed with worry in all of this. I watch him laying in his crate and I try to figure out if he is ok, or going to be ok, and it is just so hard to tell. I read things online that sometimes give me hope, and sometimes make me feel like I am putting him through a painful, awful struggle. He seems depressed and not himself. I know some of that may be do to the pain medicine, stress, and discomfort, and this is not something that just goes away overnight. But it is so hard to see him like this. The vet gave us the impression that we were basically taking a big chance by not doing to surgery and I am feeling very guilty about that as well. But, a lot of what I have read online indicates that if we really are strict with the crate rest and correct medicines, he has a chance to improve. As I mentioned, he is walking. Sometimes, his walking looks almost 100% normal. I hope I am doing the right thing. I am supposed to call the vet tomorrow to give them a progress update, and then we are scheduled to take him back in on Monday for another appointment. Is it normal for him to just lay or sleep in his crate basically all day? That's all he seems to want to do. I also ordered some organic pumpkin puree to help with his digestion, and this supplement: www.amazon.com/gp/product/B00117OM0U/ref=oh_aui_detailpage_o03_s00?ie=UTF8&psc=1, but I am going to check with the vet to see if that is ok to give him. Should I ask the vet about getting him some pepcid AC as well? Thank you for any support. We are wishing everyone else dealing with this awful condition the best of luck.
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Post by Julie & Perry on May 11, 2017 12:03:44 GMT -7
Hi Carolyn. I'm Julie. You're doing exactly the right thing for Buckeye by crating him. It sounds like he's still in pain. He may need a higher dose of Tramadol and you could also ask your vet about adding Gabapentin. It works well in controlling pain. Many dogs get well with conservative treatment done strictly for 8 weeks. Buckeye being able to still walk and having bowel and bladder control is an excellent candidate. At www.dodgerslist.com go to the IVDD 101 section. There's a 10 minute overview to get you started and lots of great information about IVDD. Knowledge is power to help you advocate for Buckeye. Healing thoughts and prayers. Yes about the pepcid AC. Steroids produce extra stomach acid and can lead to stomach ulcers. Ask your vet it it's OK to give Buckeye pepcid AC or any generic with famotidine as the active ingredient. He will take it 2x a day and gets it 30 minutes before steroids.
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Post by Carolyn & Buckeye on May 11, 2017 12:25:08 GMT -7
Thank you so much, Julie! I will ask about both the Gabapentin and the Pepcid.
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Post by Romy & Frankie on May 11, 2017 13:37:54 GMT -7
Hi Carolyn, welcome to Dodgerslist. Everyone here has a dog with IVDD so you have come to the right place. Surgery is often considered in the following situations: • If your dog can't walk OR with STRICT crate rest, neurological functions worsen and are lost (legs and bladder control) • STRICT crate rest is employed and after several attempts to go off of the anti-inflammatory, the pain returns • If 100% STRICT crate rest has been employed and pain medications have been adjusted (dose, frequency, and mix of pain relievers) yet the pain can’t be brought under control • if a dog is experiencing similar signs of neck or back pain, or mild neurological deficits for the 3rd or 4th time, meaning it may be the same disc is involved. Dr Issacs, DVM, ACVIM (Neurology) has an article about surgery here that talks more about this: www.dodgerslist.com/literature/surgery.htm I agree with Julie that Buckeye is in pain. Not wanting to leave his crate and yelping when picked up are signs of pain. Sometimes it takes three medicines each attacking pain differently to get full relief. Methocarbamol for painful muscle contractions. These are particularly likely with neck disks. Tramadol Rx'd 3x/day as the general pain reliever. Gabapentin for nerve pain also Rx'd 3x/day. Please call the vet as soon as possible and advocate for the addition of Gabapentin and Methocarbamol. There is no reason for Buckeye to be in pain. Pain only slows the healing process. When the pain meds are correct there will be full pain relief within one hour and no pain between doses. As Julie pointed out, it is very important that his stomach be protected with Pepcid AC. The usual dose in dogs is 0.44mg per pound every 12 hours. Give it 30 minutes before the anti inflammatory. 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, Pepcid AC or the generic famotidine are available in any drug store Current med list [19 lbs Prednisone as of 5/9: 5mgs 2x/day for 5 days taper 5/13 5mg 1X day for 10 days 5/22 5mg every other day for how many days?
Tramadol 50 mgs 3x/day Pepcid ?] Giving Buckeye pumpkin is a good idea. Pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. Note alternatives: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potato. The amount of water in the diet makes all the difference. --To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. <= Buckeye -- To firm up the stool add 1 teaspoon pumpkin 1x a day to kibble and no extra water. ☐ What was the date you saw the vet? ☐ Let us know you are on the same page about crate rest. The hallmark component of conservative treatment is the crate rest part. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm STRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times. Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! www.dodgerslist.com/literature/slingwalk.jpg A disc problem in the neck can be more painful and may take longer to resolve because a dog moves its head with almost all actions and whenever any part of the body moves. That constant movement means that healing can take longer because the neck doesn't get the rest to allow the disc uninterrupted healing. Here are some tips for taking care of a neck disk: www.dodgerslist.com/literature/cervical.htm It is very scary when our dogs have IVDD. It becomes less so when we learn all we can about the disease. An excellent page to start with is "Overview: the essentials" and then read all you can as soon as possible. Here's the link: www.dodgerslist.com/healingindex.htm
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Post by Carolyn & Buckeye on May 11, 2017 20:28:22 GMT -7
Thank you so much Romy. We are doing exactly what is outlined for the strict crate rest. Literally I do not take him out of the crate except to take him out to potty, but I physically carry him out and while on a leash, let him take very brief steps to go, then pick him up and return him to the crate. The only other time I move him is to move him to a different crate in my office (I work from home) while I am working so he can stay with me all day. I am calling the vet first thing tomorrow to try and get the additional pain medicines you and Julie outlined added to his regime, and I will post with updates once I know more.
Thanks again, Carolyn ❤️
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Post by Pauliana on May 11, 2017 21:59:32 GMT -7
Carolyn, here is a video to show you how to lift and carry Buckeye now that he has been diagnosed with IVDD. dodgerslist.com/literature/liftcarry.jpgIt sounds like you are taking wonderful care of Buckeye.. We will be looking forward to your updates!
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Post by Carolyn & Buckeye on May 12, 2017 7:54:44 GMT -7
Thank you Pauliana! That is very helpful!
Update:
I just spoke with the vet's office, and I asked about the Gabapentin, the Pepcid, and the Methocarbamol. This is what they said:
They are prescribing him the Gabapentin. I am unsure of the dosage right now, I will update when I pick that up from the pharmacy, as it had to get called in to an actual pharmacy rather than just getting it at the vet. Additionally, they said to hold off on the tapering of Prednisone until Monday 5/15. (The taper to 1x per day was supposed to start tomorrow). They said Not to give him the Pepcid right now since he is not currently having any stomach issues, and they are against using it as a preventative unless he was taking something stronger on the stomach, like an NSAID: for example Rimadyl was the example they gave. I pressed this, but they said part of their reasoning is that they add 1 medicine at a time, so that if something is Not working the way we need, or there is a problem, we don't have to play a guessing game to figure out what it is.
[19 lbs Prednisone as of 5/9: 5mgs 2x/day for ▲7 days, then taper 5/16 Gabapenin ? mgs ?x/day Tramadol 50 mgs 3x/day]
I asked about the Methocarbamol, and they said once again, they would hold off on prescribing that until we can see if the Gabapentin is helpful for his pain management first. Same thing when I asked about increasing the amount or frequency of the Tramadol. Our next appointment is Monday, 5/15, so of course if we don't have improvement by then I will be asking the same questions again. I also asked if I should be staggering the times I give him the Tramadol and Gabapentin, (my reasoning was maybe that way it would provide him better coverage over the timespan between doses), but she said it was not necessary. She said I could try that if I wanted, but didn't seem to think it would make much difference.
Romy, to your question in the last thread regarding the Prednisone (how long?)-the pill bottle had 30 pills in it to start, and the part for:5/22 5mg every other day for-how many days? It says "until gone". So this may be something that will likely be revisited, since we are increasing his dosage still to 2x per day through Monday, and that was not part of the original RX. Let me know if that makes sense.
An additional update. I noticed yesterday that he seemed more uncomfortable than he had been in the evening and I became worried. (He shuffled around more than usual in his crate to get comfortable and then randomly yelped out, which he has not done). Then when I went and checked on him he seemed like he didn't want me to bother him, so I let him rest. Then when I came back to give him his evening dose, (Pred and Tram), I was fixing up the blankets in his cage and I found a Prednisone in full shape(!) under a blanket so he must have spit that out or coughed it up after his morning dose, and no wonder he was uncomfortable. Poor guy. I blame myself completely, but I am always very careful to check to make sure he swallows the pills, but now I will be even more careful. What I will be doing from now on is to give him a little bread or cheese first, then the pill(s), then bread or cheese again, that way I figure he cant cough it up or anything like that without me realizing. I will also be doing random checks in his crate from now on to make sure that doesn't happen again.
Does anyone have any other recommendations or advice they might share for a better method, or their own experience of giving pills? I saw somewhere there had been a recommendation of putting a pill in a spoonful of coolwhip and I was thinking of trying that. I don't want anything like that to ever happen again.
This morning, he seemed to be a little more himself, and seemed very happy to see me which was really nice. He is now resting in his crate by my desk.
Thanks for all of the support, Carolyn and Buckeye
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Post by Julie & Perry on May 12, 2017 8:33:04 GMT -7
Carolyn, cervical IVDD is usually very painful. That's why there's usually Methacarbomal for muscle spasms, Tramadol for general pain and Gabapentin for nerve pain. Tramadol and Gabapentin actually work better when given together. Steroids are great for reducing swelling from IVDD but are also well known for creating extra stomach acid and causing ulcers. All pepcid AC does is reduce that extra acid. If you wait to give it then it could lead to dealing with an ulcer, diarrhea, stomach upset. How much experience does your vet have with IVDD? Many not familiar with it are reluctant to "overmedicate" for pain. They don't realize how much IVDD episodes can hurt. If Buckeye is showing any signs of pain the wait and see approach isn't good enough. As for taking pills, a good approach I've heard of is taking three yummy treats and putting the pill in one. Give non-pill treat first. Next, treat with pill. Then non-pill treat. The idea being is they'll gobble them all down quickly and not worry about a pill. I know it's hard bucking what the "experts" say but sometimes they're wrong. Do what your gut tells you Buckeye needs. Good luck. At www.dodgerslist.com go to the IVDD 101 section. There are sections on cervical IVDD issues and medications. Information is power!
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Post by Carolyn & Buckeye on May 12, 2017 9:13:55 GMT -7
Thanks Julie. I hesitate to go against a vet's advice, which is why I kept pressing it with her. I did specifically ask the question: Is there any medical reason NOT to give the Pepcid to Buckeye, and I suppose in the gray area, she didn't officially say NO definitely don't give it to him, she said they 'don't recommend it' only because they don't want to over-medicate him, but is that a legitimate medical reason? Is an antacid taxing on the liver/kidneys? What if he is already having gastro discomfort I am just not aware of? My gut on this one makes me just want to give it to him as long as he is on the steroid. This is a general DVM, to answer your question. They seem knowledgeable but honestly I have gotten more relevant and helpful information on this site, up to this point.
We basically were given the impression the IVDD outcome was either an invasive surgery, or a death sentence, and we were pressing our luck by doing conservative treatment. That being said, I think that is their general stance, as in, not specific to Buckeye's case specifically. When I kept asking about getting him more pain meds, she said, 'well if this next step doesn't work, we will need to talk about.... "next steps"... which, as they are aware we are unable to do the surgery, I believe in this case is vet-code for euthanasia. I certainly understand that the 8 weeks of crate rest is supposed to be pain-free to be effective, and I want to do my part to advocate for Buckeye to ensure that is taking place, IF it is possible. I have come to terms with the fact that it might NOT be possible, but I remain hopeful and I want to try to get him whatever he needs, including additional medication if necessary. I'm going to do a quick Vet rant here for a sec, but, I do NOT think it is appropriate for them to bring up or recommend a route like euthanasia as opposed to first trying out different levels or types of pain medicines. Buckeye was playing at the energy level of a puppy on Monday before this happened.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on May 12, 2017 9:14:49 GMT -7
Carolyn, kudos for getting a 2nd pain reliever on board and a one day extention of pred.. It is clear your vet is not comfortable in his knowledge of IVDD in reluctance to do conservative with a walking dog and making you think IVDD not surgically treated is a death sentence. This makes it doubly important that you be highly educated to drive Buckeye's treatment, hire a 2nd opinion vet if need be and be able to identify any harmful advice and say no thanks. Reading and learning as soon as possible will be a great aid to you in advocating and protecting Buckeye from needless pain or harmful advice: www.dodgerslist.com/healingindex.htmWithin one hour of given the pain meds (tramadol and gabapentin) if you do not see full pain control, then the prescription is not yet right. I would then advocate for ----methocarbamol for the very typical muscle spasm pain that comes with neck discs and prescribed 3x/day --- Gabapentin to be prescribed for 3x/day if it is was not. --- The only question to ask about Pepcid AC is a very, very specific one. Does my dog have any health issue to prevent use of Pepcid AC (famotidine)? IF there are none, then you buy it at the grocery store. Your vet does not appreciate the damage any NSAID, any steroid can do to the GI tract. He does not appreciate that when a dog's routine has been changed, that is stress and the body will produce more acids! Dog's don't speak up like a person would at the first signs of acid damage caused by steroids (nausea, not eating, diarrhea, bleeding ulcers, bloody stool, perforated stomach lining). So we are big followers of the vets who appreciate a real chance of GI tract damage that the manufacturer of prednisone warns about in the package insert and don't take chances by calling for an acid suppressor like Pepcid AC. Owners reading up on each of their dog's meds will always been an important safety factor. I LOVE this vet's website for that purpose. Here is the link to the drug directory so you can read the full info on Pepcid AC: www.marvistavet.com/pharmacy-center.pmlA disc episode is not rocket science in its treatment. It is not a newly discovered disease that no one knows anything about. So there is not a need to use Buckeye as an experiment to see if GI tract damage might happen. Buckeye does not need another problem to deal with on top of the disc problem. It is very well known that disc episodes are typcially quite painful. So when it is known there are three typical sources of pain, there is no need to experiment with Buckeye to nail down where the pain might be coming from. The best pain control during a disc episode comes by using more than one approach to address pain from multiple fronts. All pain is not alike…it can be complicated. Pain often stems from: nerves, from muscles/skeletal, internal organs. Different pain receptors are blocked by different chemicals….thus the potential need for several classes of pain meds to deal with a disc episode. Getting dose to dose pain relief will happen in an hour when the meds are right for your dog. Working with your vet or finding a new vetwho will work with you, giving prompt feedback about pain is how the meds are tweaked (change mix of pain meds, adjust the dose in mg and/or the frequency) to get it just right for your dog. The World Small Animal Veterinary Association (WASAVA) guidelines for vets: 1. We can’t always know that our patient does hurt, but we can do our best to ensure that it doesn’t hurt.2. Response to appropriate treatment is the gold standard to measure the presence and degree of pain. 3. Pain assessment is key to determining the degree and duration of pain treatment but should not replace the adage of treating predictable pain
www.wsava.org/sites/default/files/jsap_0.pdf
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on May 12, 2017 9:22:18 GMT -7
If you are up to driving Buckeye's treatment and your vet will be open to learning what you have learned from our main web page: www.dodgerslist.com then he may well be able to guide you through this disc episode. If you are finding it hard to read and learn, do not see yourself emotional strong to move up to being the captain of Buckeye's health care team, then finding a vet who knows IVDD will be like night and day in support with proper meds, supportive of your choice for conservative treatment. How to find an IVDD vet: www.dodgerslist.com/literature/VetchkList.htm
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Post by Carolyn & Buckeye on May 12, 2017 9:53:34 GMT -7
Paula, thank you so much. I am going to look at all that information, and discuss all of this with my husband this evening. Then we are going to make the decision of whether to move to a different vet. We have the appointment on Monday already scheduled, and I do plan to see that one through to see what else they have to say regarding his treatment at that time rather than starting over with someone new right now, but if we are not on the same page with them at that point I will be looking for another vet. I am already planning to call a couple of local places today to see if any one else has more to share with their level of expertise with IVDD. I really appreciate the support and encouragement.
Update: Buckeye is snoring peacefully in his crate. :-)
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Post by Carolyn & Buckeye on May 12, 2017 13:01:18 GMT -7
Another update: I gave Buckeye the Gabapentin, and got the Pepcid as well. The Pepcid (generic) box says it is 20 mg, and Buckeye is 19 lbs, I believe the correct dosage of the Pepcid would be 5mg 30minutes before the Prednisone, but can anyone help make a suggestion on this? I just want to know how small to cut the pills (1/4s?). [19 lbs Prednisone as of 5/9: 5mgs 2x/day for 5 7 days, then taper below anti-inflammatory dose Tramadol 50 mgs 3x/day Gabapentin 100mgs 2x/day Pepcid AC 5mgs 2x/day]I mixed some of the pumpkin with his wet food and a bit of kibble for lunch, and he seemed to enjoy it. He does not seem to be interested in the pumpkin by itself, or when it is mixed with just kibble. He just got back from a BM and he is so far the perkiest I have seen him since this happened. BMs still look very normal to me. The Gabapentin prescribed today 5/12: 100 MG capsules QTY 60-1 capsule by mouth once or twice daily (I am planning on doing 2 pills per day for now). The instructions say not to let him drive a car or operate heavy machinery, so we will be holding off on that too. :-) I have been playing relaxing music for him all day today and that actually seems to be helping too. I found some music on youtube for for dogs, and we played that first (it sounded kind of like music they play at the spa), but now we have switched to Marconi Union-Weightless which has actually had studies done on people about helping to reduce anxiety and help people fall asleep. I know people's brains are different than dogs, but he seems to be enjoying it. www.inc.com/melanie-curtin/neuroscience-says-listening-to-this-one-song-reduces-anxiety-by-up-to-65-percent.htmlThis is a 10 hour loop of that song: Best, Carolyn and Buckeye
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Post by Romy & Frankie on May 12, 2017 13:14:33 GMT -7
I am glad that Buckeye is sleeping peacefully now.
I agree that your vet should not be bringing up euthanasia. We have heard of this too often. Hopefully your vet will be open to additional pain meds and you won't have to change vets.
If he doesn't like the pumpkin you can try really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potato.
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Post by Carolyn & Buckeye on May 12, 2017 20:35:48 GMT -7
Another brief update:
Buckeye seems to be doing much better with the addition of Gabapentin. He has not yelped at all since his first dose, including when I have lifted him to take him out to go potty, and he has had a few times where he seems much more lively and back to his normal self. He seems much more interested in what is going on, and looks up and makes eye contact/seems curious etc. He is still sleeping and laying down quite a bit, as he was before, but seems to be moving around a lot less to get comfortable and he seems to be sleeping more peacefully (lots of contented snoring). On his last potty trip, he was walking with basically a normal gait once he got moving, and I actually really had to curb his sniffing and walking to take him back in. He still is reluctant to leave his cage but I suspect he feels anxious about it because it was causing him some pain before. He also seems to be sturdier when I lift him.
I will continue to monitor him to ensure we are looking for any signs of pain or discomfort to see if we still need to look at additional pain medicine regulation, but so far I am VERY happy to see this improvement.
Thank you so much to everyone who provided us with support, guidance, and advice (or even just positive thoughts sent our way). I will continue to post with updates on Buckeye's progress.
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Post by Pauliana on May 12, 2017 22:02:54 GMT -7
Hi Carolyn!
Buckeye is sleeping better because Gabapentin and also Tramadol can make dogs (and People) sleepy..Great sign that Buckeye is not in pain.. If you do see signs of pain, Gabapentin like Tramadol is short acting and works best given 3 times a day.. Call Vet IF you see pain between doses and ask for 3 times per day..
If NO pain arises then two times a day is working for Buckeye and that is great! Not wanting to leave crate can be pain or fear of pain.. The best way to tell for sure is to look for other pain signals such as shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy, restless, can't find a comfortable position. Ears pinned back, arched back. Holding front or back leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky selves. Full pain relief is expected in 1 hour and stays that way dose to dose of correctly Rx/d pain meds.
Glad Buckeye is feeling better!
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Post by Brenda & Shooter on May 13, 2017 15:36:26 GMT -7
Hi Carolyn! It seems as though your Buckeye and my Shooter are in similar condition. I am preparing to discuss an alternate treatment plan with my veterinarian. Can you share with me how long your veterinarian intends to have Buckeye on the Gabapentin and Tramadol?
Maybe others here are willing to share their experience administering this two medications?
Also, will you be considering the addition of Sucralfate for additional GI protection?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on May 13, 2017 17:34:52 GMT -7
Brenda, the quick answer as to how long to use meds for a disc episode, is that no one knows. Every dog is individual, each disc damage can be different. So a vet must simply guess by Rxing typically a 5-7 day or 14 day anti-inflammatory course (either a steroid or a NSAID). Never are steroids and NSAIDs mixed nor used in close proximity. Because steroids or NSAIDs are not pain relievers since it may take 7-30 days (comprised of several courses) before the painful spinal cord swelling has been resolved, then pain-masking meds are a must. At the end of the anti-inflammatory course NSAIDs are stopped and steroids are tapered as a test for pain. Pain-masking pain medications are also stopped so the owner at home can make a clear and accurate assessment about pain for the vet. If there is pain, then another course of the anti-inflammatory is Rx'd. Rule of thumb Pain= another course of anti-inflammatory + all pain meds back on board. No Pain= no need of any meds...just finish out the 8 weeks of crate rest for the disc to heal. Check out the full details on how anti-inflammatory drugs work with a disc episode. Good reading to be able to ask the right questions and discuss treatment with your vet: www.dodgerslist.com/literature/healingsweling.htmBrenda, if you have more questions, please pose them on Shooter's thread dodgerslist.boards.net/thread/5056/brendas-shooter-conservative-neck-terrier . That way we'll have his history handy and best be able to provide meaningful comment. Let us know how Shooter is doing pain wise since his meds had to be stopped.
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Post by Carolyn & Buckeye on May 13, 2017 19:39:23 GMT -7
Hi Brenda! I am so sorry to hear about Shooter. ☹️ This is so overwhelming, but like you, I am so glad to have found the information and support from this forum and site. It is exactly why I had the confidence to call my vet and request the Gabapentin in the first place (as you can see from my posts so far that has been a huge improvement for him). I am actually unsure how long Buckeye will be on those meds, from what I understand, I think the duration for the meds is very dependent on his individual progress and ability to stay pain and inflammation free. I think we have to first get his inflammation down with the prednisone, and then look to hopefully reducing the pain meds after that, once he is truly not needing them to stay pain free during the remainder of his crate rest treatment. His RX originally is for 30 days but I do think that's just originally what they gave us, I don't think that is specific necessarily to how long he would be on them. We have another appt on Monday so I should know more then.
So far the only stomach helper med we are doing is the Pepcid and so far he is fortunate to not have any noticeable GI troubles, but I am keeping a close eye on that.
Good luck with Shooter! You both will be in my thoughts and prayers.
----- Thanks Pauliana! [re: pain and meds explanation]
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Post by Carolyn & Buckeye on May 14, 2017 17:39:04 GMT -7
Buckeye still seems to be improving today! All the treatment and meds are currently the same, but today there was much more tail wagging, increased level of interest, better appetite, and what looks to be a normal gait when waking during potty time. He doesn't drag a toe or anything like that, he just seems to be getting better. He gets up on his own now to come out of the crate when it is time to potty (sometimes a little coaxing if he is tired) but not always, and he seems just generally happier and more to his normal self. We are very happy with his progress and will absolutely be continuing the strict crate rest and meds. His checkup appt is tomorrow morning, so I will be sure to post with any additional updates.
Very happy dog mama here. I am extremely hopeful he will make a good recovery.
Thanks again for all the support, Carolyn and Buckeye
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on May 14, 2017 19:48:11 GMT -7
Carolyn, good to hear that Buckeye has his pain fully under control.
Was the pred taper day changed from starting today, Sunday, at 5mgs once a day? Was the anti-inflammatory dose of pred at 5mgs 2x/day extended beyond a 5-day course? how many more days?
19 lbs Prednisone as of 5/9: 5mgs 2x/day for 5 days, then taper below anti-inflammatory dose Tramadol 50 mgs 3x/day Gabapentin 100mgs 2x/day started on 5/12 Pepcid AC 5mgs 2x/day
The focus on conservative treatment is limited movement of the spine. When a phone call update to report good news or reporting specifics of pain to seek adjustments to meds can be done over the phone, that is the safer idea than a risky-to-the-disc vehicle transport. When the benefit of a vet visit outweighs a potential risk to the healing disc, then pad out the crate with a rolled up blanket so his body will not shift with cornering or braking.
Often when prednisone begins a taper the pain-masking pain meds are also stopped. This is done so you at home can determine if the swelling in the spinal cord is gone with a speedy and accurate test. It is existing swelling that causes the pain and possible neuro deficits. If the dog is still taking pain meds it will mask the pain that indicates the swelling is still there. As pred is tapered to doses below the anti-inflammatory level, pain meds have been stopped, no pain surfaces, the swelling is gone and pred would continue the taper to conclusion. All that remains is to complete the rest of the 8 weeks to let the disc finish healing. If pain surfaces on the pred taper, another course of pred would be prescribed, all pain meds back on board and Pepcid AC too.
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Post by Carolyn & Buckeye on May 14, 2017 20:34:32 GMT -7
Hi Paula,
Currently the prednisone is scheduled for 2x per day, until the end of the day/night tomorrow. IE starting Tuesday, we are scheduled to start on 1x per day in the AM. Then I believe after a week it switches to 1x every AM every other day until the 30 pills are gone.
Based on your post, I will call the vet first thing tomorrow to report his progress and see if it is still absolutely necessary to bring him in for the appointment, or if they would be alright with me reporting on his progress to begin the taper. I'll report tomorrow with an update of any changes to medication. Thank you so much for the information you shared, I will be asking questions tomorrow about what their recommendation is regarding the pain meds as well.
Thanks again for all of the information and support, Carolyn and Buckeye
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on May 15, 2017 6:21:57 GMT -7
Carolyn, thanks for the correction on how many days the pred course was for. Prednisone started as of 5/9: 5mgs 2x/day for 5 7 days, then taper below anti-inflammatory dose Very curious, then, why a call for a vet visit on 5/15 before there would not be any evidence yet from a test-for-pain taper on starting on 5/16. The important part of prednisone is the course up at the anti-inflammatory level. When the taper starts those doses are no longer working on painful spinal cord swelling and thus we do not count those days as part of the possible 7-30 days it might take before all swelling has been resolved. Since pain was not controlled until the addition of gabapentin on 5/12, it can be very possible that now only 4 days later the swelling may still be existing....just now being well masked by pain meds. When you speak with the vet he may want to extend the 7-day pred course a few more days or he may want to go ahead taper tomorrow to find out for sure if swelling is still there. Most vets will just stop pain meds if they have only been used for a short time as has been for Buckeye. When a dog has been on pain meds a long time, some vets will want to back them off rather than a cold turkey stop at the start of the pred taper. Do let us know what your vet wants. Nice relaxing music you found. You may want to mix it up with others so your ears don't get bored. Check out our supplies list for more relaxing 10 hr YouTube music: www.dodgerslist.com/literature/cratesupplies.htm
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Post by Carolyn & Buckeye on May 15, 2017 6:47:00 GMT -7
Hi Paula,
I just spoke with the vet, and they were alright with me just doing an update for them over the phone, to prevent the unnecessary movement for Buckeye during transport. I am very glad for that advice, and I believe it was best to not move Buckeye-thank you!
I asked about the Prednisone, and I also asked about the pain medicines stopping. She said that we will begin the Prednisone taper down to 5mg 1 x a day starting tomorrow, with all pain medicines remaining the same. I asked why that was, and how would we know if the inflammation was still there, and she said the way they do it is to reduce the Prednisone first, and then once the Prednisone treatment is complete (May 31), that is when we discuss stopping with the pain medicines. Also, if there are any changes to his comfort level, I am to call back and let them know right away. She also said we need to go for an an-office appointment in 2 weeks, so that is scheduled for May 26, and she said we can discuss his medicines again then.
I know this is not in line with what you had mentioned, but I am not sure what to do. We did decide to stay with this vet. I spent hours on Friday calling around, and every place out here that is remotely drive-able are all general practice, with the exception of a neural specialist and hour away that wants to begin by doing an MRI. The general DVMs would just say that they had 'seen' IVDD, but they didn't specialize in it, and that every treatment is different, and they would need to see Buckeye first before they could give me any more information.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on May 15, 2017 10:31:58 GMT -7
Carolyn, good job on protecting Buckeye's healing disc with presenting the idea of a phone update!! Kudos to you.
So they are willing to have nothing addressing swelling during the taper of May 16-31th ( 16 days) IF, if there should be swelling still existing? Since they have already prescribed a range of Gabapentin of once or twice a day, why not ask what is the harm to move down to 1x/day and ask about moving tramadol down to 2x or 1x/day. Gabapentin 1x and Tramadol 2- or 1x/day is like not giving any. Backing off the pain meds then would give you a much clearer, non-delayed picture about pain IF there would be a need to get back up to the original dose of pred because.
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Post by Carolyn & Buckeye on May 16, 2017 14:25:12 GMT -7
When reducing the pain medicines with the pred taper, how long after reducing the pain medicines should we be looking for any signs of inflammation? Are there specific signs to look for, or are they just the typical pain signs? The vet said they recommend keeping him on the pain meds as dosed to help him stay calm and resting during his treatment.
I had skipped the afternoon doses for pain (this would reduce the ▼Tramadol to 2x per day, and ▼Gabapentin to 1x per day) because I was worried about looking for inflammation, and already he is acting like a ball of energy, barking for attention, wanting out of his crate, up a lot more just acting bored and wanting to play. 19 lbs Prednisone as of 5/9: 5mgs 2x/day for 5 days, then taper below anti-inflammatory dose Tramadol 50 mgs ▼2x/day Gabapentin 100mgs ▼1x/day started on 5/12 Pepcid AC 5mgs 2x/day
I know those are generally good signs when it comes to how he is feeling, but I don't want him trying to jump up and trying to claw out of his crate, or even barking (think deep beagle bark with the neck movement). He does Not seem to be in pain, he is moving around very well, good appetitie, no yelps, or anything like that. He has a normal gait and even tried to break into a run when he saw a rabbit in the yard today. He just seems desperate to get out of his crate.
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Post by Romy & Frankie on May 16, 2017 14:59:24 GMT -7
I am glad that Buckeye is feeling better. That is when they want out of the crate. If he was in pain again he would just show the typical symptoms such as; shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, can't get comfortable, tight tense tummy. The pain may show up quickly, but it takes a few days for all the medicine to leave the body so it could be longer. These are some of the things that have worked for our members to keep dogs calm in the crate. Sometimes just placing a blanket covering the top half of crate which creates a den-like feeling can help to calm: www.dodgerslist.com/literature/EmergencyCrate%20Training.htmOther things to try are using an oral calmer in combination with a Pheromone diffuser. This seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. with. Of course ALWAYS keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price. Place a DAP pheromone diffuser at floor level where the recovery suite is. Some brands to consider: --Comfort Zone (DAP) wall plug-in diffuser www.comfortzone.com/dogs/products--Adaptil (DAP) wall plug in diffuser www.adaptil.com/Use a diffuser with one oral calmer from below: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. www.vetriscience.com/composure-soft-dogs-MD-LD.phpBach's Rescue Remedy is a liquid herb combo to help with relaxation www.bachflower.com/rescue-remedy-pet/Let us know how the taper is going for Buckeye.
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Post by Carolyn & Buckeye on May 18, 2017 7:15:58 GMT -7
Thanks Romy! I ordered the oral calmer and diffuser; I hope we have good luck with those! Buckeye still seems to be improving each day. Thanks for all your help!
Best, Carolyn and Buckeye
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Post by Carolyn & Buckeye on May 18, 2017 18:54:13 GMT -7
Buckeye had a bit of a rough evening. We are on the one dose of prednisone now and the reduced pain medicine as listed, and this evening [5/18] he started trembling and panting and wouldn't settle down. At first we thought he just wanted to get out of his crate (he pants and acts jittery when he is overly excited in general, although I know those are also pain signs to look for). After a few hours of him not settling down I became worried and gave him the ▲Gabapentin at about 9 this evening (he hadn't had any Gabapentin since this morning and I had planned only the one dose today). Prior to that I was dosing him as was listed in our post. He seems to be settling down now, he finally layed down in the crate, but now I am worried that he had a painful day. I am planning to call the vet first thing in the AM but I wanted to give an update. It seems likely that he still has some inflammation? I am now wondering if they will re-start the prednisone schedule for the inflammation dose at 2x per day. :-( This is all so worrisome.
[19 lbs Prednisone as of 5/9: 5mgs 2x/day for 5 days, then taper Pain surfaced on taper on 5/18 Tramadol 50 mgs 2x/day Gabapentin 100mgs ▲2x/day Pepcid AC 5mgs 2x/day]
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Post by Julie & Perry on May 18, 2017 19:11:15 GMT -7
Yes it does sound like there's still inflammation and pain. My Nala usually has to have two tapers of Prednisone and some dogs need more. Any way to talk to your vet tonight and get the OK to bump up the Prednisone and Gabapentin again?
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