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Post by maxismom on Jun 27, 2013 11:21:24 GMT -7
HI Everyone! My name is Kait. I have a 4.5 yo MN dachshund. He weights 16.5lb lbs (good body condition). I have had him for about a year and a half and this is his 3rd episode. Max was given to me as a foster originally. When I got him he was already on strict crate rest as well as prednisone, pepcid, and tramadol. He was given up by his family because the children were too rough with him, which is supposedly what started his back issues. I do not know if he was diagnosed specifically with IVDD. After the first episode he went back to 100% for about a year. 3 months ago Max was playing and became painful, yelping when picked up, stopped going up steps (he has never gone downstairs since I have had him). He only responded mildly to manipulation of his lower back, tensed up but no yelping or any other signs at the vet. She put him on dex and crate rest. In about 3 or 4 days he seemed to be feeling much better and after his 2 weeks crate rest was back to his old self but never started going up steps again. Max is an extremely active dog, loves running around, will play fetch until the ball falls apart, rarely ever naps. Over the weekend max became interested in the hose and while cleaning the car he jumped in the air to get at the water and since then has been the worst I have seen him. He keeps his head down, back is arched, neck is having muscle spasms, when he wants to shake his head he stops immediately, cries when he is picked up, and very lethargic. Again I brought him to the vet but this time when she manipulates his back, neck, legs, anything he does not respond at all. It is very frustrating because we can not tell where the pain is. She was going to test him for lyme disease but he did not have a fever, he is eating well, no vomiting, and since he has a history of back pain she is treating him for that. He is on pred 10mg once daily and after 4 days seemed to be a little more comfortable until this morning. After eating breakfast he was holding his head down again, his back was arched, and he screamed when I picked him up and started having neck spasms again. So i called the vet today and she said I did not need to bring him in, instead she added tramadol on board. She is also recommending a chiropractor. I am at a loss of what to do right now. I feel like after 4 days on pred he should not have gone back to day 1 painwise. Also, I think that a chiropractor would make things worse for him. I called a vet that does acupuncture which I would love for him but of course its very expensive. I have health insurance on him but it does not cover that unfortunately. I'm just looking for some feedback, as well as any advice on the chiropractor. Its killing me to see such a happy active boy so lethargic and miserable  Thank you in advance! Kaitlyn and Max
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,610
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Post by PaulaM on Jun 27, 2013 12:52:46 GMT -7
Kait, welcome to Dodgerslist. From the pain you describe, it can quite possibly be a neck disc. These are the things you need to address right away today. 1. Pain meds are not yet being prescribed to control pain. Right off the bat most vets prescribe TWO pain meds (Tramadol and methocarbamol). IF that is not controling pain, then a 3rd gabapentin is added. Your vet is really not comfortable in treating disc disease with under prescribing of pain meds. UNDER no circumstances should chiro be use with a known or suspected IVDD dog. The reason why: www.dodgerslist.com/literature/chiropractic.htm Learn the meds used with IVDD and advocate strongly for the right pain meds being on board: www.dodgerslist.com/literature/healingpain.htm2. Do the extra things to help with a neck disc: www.dodgerslist.com/literature/cervical.htm3. What date was pred started and has there been a reduction in dose recently…a tapering off? That would be an explanation of pain too. 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. NOTE: neck discs can be much more painful and take longer to get all the swelling down. Rule of thumb is: pain = swelling = more time on Pred needed. If there is no pain on the taper then it goes to completion. Then no meds at all are needed any longer. To have a clear picture on a taper, pain meds are also stopped or back off too. This is one disease we owners have to do more than just follow vet instructions…we have to step up and become the health care team leader by reading and educating ourselves. We have to be able to ask good questions and discuss things and ignore when harmful advice is being given. This is really the best place for you to get up to speed on all things IVDD. Start with the Yellow "overview" and then read all of the orange buttons. Let us know what changes your vet has made to help get the pain undercontrol. Care will be so much easier when pain is fully under control dose to dose of the pain meds. |
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Post by maxismom on Jun 27, 2013 15:46:47 GMT -7
Thanks Paula.... When I got home from work today his neck muscles were twitching so I called the vet and now he is on tramadol as well as methocarbamol. He started the pred Saturday but I'm not due to taper until this coming Saturday so I'm not sure why he went backwards. It is confirmed that it is his neck, rather than his back. I had to hold up his bowl to his mouth for him to eat today. I will let everyone know tomorrow how he is doing with all of the medications. Also, I got famotidine at the store today! So happy about this site.
Max's medications are pred 5mg twice daily, tramadol 25mg every 8 hours, and methocarbamol 500mg 1/4tab every 8hrs. He weighs 16.7lbs.... Do the doses sound appropriate?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,610
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Post by PaulaM on Jun 27, 2013 17:41:52 GMT -7
Wahoo, Kait, kudos to you gal for advocating on behalf Max, well done! IF the current dose, frequency and mix of meds is keeping pain at bay, then they are right for Max. If you should see pain surfacing after moving say at potty time or nearing the next dose of pain meds, then you know they are still not right. Your vet has not maxed out what can be given for a 16 lbs dog…so she still has plenty in her arsenal to get pain control just right for Max should his meds need a bit more tweaking. Keeping her updated with your observations is key, so she would know if all is not well and additional pain control steps would be needed. When the taper of pred does start, you will then want to be very observant for signs of pain. It is not uncommon at all for more than a week on pred to be necessary to resolve all the swelling. No one wants to use these big gun and big adverse side effect meds one bit longer than necessary. So trying a taper when a vet guesses the swelling might be gone is a prudent thing to do. The neck discs are harder and take longer to heal because of the head naturally moving when other parts of the body move. So as soon as you can get his bowls at head height in the crate, soaking his kibble so he does not have to crunch and the other tips mentioned will greatly help Max. We are glad you found us too! I was so rushed in the last post I forgot to give you the start page to getting up to speed on the disease and it's care: www.dodgerslist.com/healingindex.htm Check out each of the colored buttons, you won't be sorry, you'll be empowered to advocate for Max! |
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Post by maxismom on Jun 30, 2013 11:19:03 GMT -7
Update on max: he was supposed to start tapering off pred however he has not improved much so I decided not to taper him. I brought him to a different vet today who gave him another weeks worth as well as started therapeutic laser on his neck. It's been a few hours since then and he is now knuckling slightly on his front left leg which is scaring me.
He is walking on it but when he stands more than a few seconds on it it starts to knuckle. He can place it himself if flipped but again slowly starts to knuckle.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,610
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Post by PaulaM on Jun 30, 2013 15:15:11 GMT -7
What exactly had not improved. As you know from your readings there are several levels of healing. Was his pain increasing, did he have any neuro diminishment before going to the new vet for laser? Is surgery a consideration for your family? You may want to calmly look into things now rather than if there is some emergency. Care Credit for no or low-interest vet cost…find out on line if you qualify. Lots more information on when to decide for surgery: www.dodgerslist.com/literature/healingsurgery.htmAre his meds the same in mg and how often you are to give them… everything just extended for another week? |
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Post by maxismom on Jun 30, 2013 15:39:58 GMT -7
I felt like he may still have been slightly painful. He was still holding his nose to the ground. There were no neuro diminishments until this afternoon. He is still using his front foot just occasionally knuckles.
Surgery is an option. I have good health insurance on him that covers 90% thankfully. I just didn't want to jump to putting him through that recovery if its not necessary.
He is on famotidine 10mg once daily, pred 5mg twice a day, tramadol 25mg every 8 hours, and methocarbamol 125mg every 8hrs. All of the meds were extended for 2 more weeks and he has another laser treatment on Tuesday.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,610
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Post by PaulaM on Jul 1, 2013 10:00:19 GMT -7
Holding his nose to the ground is most definately a sign of pain. The meds are not at the max. For instance Tramadol can be increased in mg and given more often than every 8 hours PLUS gabapentin can be added in. If the pain is not yet in control, get on the phone and strongly advocate for stronger pain management.
If the pain can't be managed when meds are being used at the max…then surgery would be a consideration. Healing simply can't get underway until pain is fully in control dose to dose of the pain meds.
Let us know if his pain is fully under control today or what the vet has prescribed to be more aggressive in pain management.
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Post by maxismom on Jul 8, 2013 9:04:59 GMT -7
Update: Max is improving every day! He is no longer holding his nose to the ground or having muscle spasms. He has been going every 3 days to get laser therapy which he loves. He almost falls asleep during his treatments. He is no longer on any pain meds because they have not seemed necessary at this time. He has about another week and a half of his pred to ween him off. Thank you for all your help and support. I have certainly learned a lot!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,610
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Post by PaulaM on Jul 8, 2013 13:38:42 GMT -7
Kait, this is really wonderful news that the taper of pred is going so well and no signs of pain. Thank you for this update…we always wonder how a dog is doing. Plus your posts help to give others just starting the journey some good inspiration.
Please do continue to let us know how things are going for Max. Go Max on healing that disc for the balance of the 8 weeks of crate rest!
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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 Jul 9, 2013 9:05:49 GMT -7
Great news!  |
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