Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 16, 2019 3:05:17 GMT -7
My 16# fixing to be 8 year old miniature wirehaired male crashed just a few days ago. In fact I cant even think straight right now. It has been a traumatic experience.
Over the past few weeks (August 1st-14th 2019) he seemed "stiff." My husband thought he was not getting enough exercise, so for whatever reason we decided to go on a hike while his family was in town. A day later he was hunched over- hardly could walk. He could still go to #1 and #2, but it was obvious he was in a bind.
We got him to the vet Wednesday the 14th, which prescribed strict crate rest, .35ml of meloxicam x 1 day with food. He said we could take him outside for potty business only.
Next morning, Tempo was totally crumpled into a ball, his feet sucked under him and his back arched so tight, unable to move. Taking him outside was a disaster. We ended up having to youtube and find out how to express his bladder so he doesn't move at all.
I called the vet 8/15/2019 to request predinizone and something else to try as we have doubled the dose of ▲meloxicam to 2x a day with food.
[Moderator's note: please do not edit 16 lbs. Meloxicam as of 8/14: ?mg (0.35mL) 1x/day as of 8/15: ?mg ▲2x/day In pain but no pain meds on board! No stomach protection on board!]
I have also given him CBD oil, Hemp seed food supplement (says helps with inflammation). I am feeding him canned salmon, rice, and green veggies that are suppose to help with inflammation.
We live remotely and getting to the local vet is about 6 hours round trip drive. We were quoted an astronomical amount to get him surgery which is not an option.
Right now we think he has a bulged disc as his LEFT side was more effected that the right as far as response and reaction. But now that he has "crashed" I am not sure what is going on. He is still in pain so we dont think he is paralyzed...No one should have to see their baby go through this.
My husband has sat by him for hours, and I have been too. We are exhausted, we wish the medicine would work better, but we know we must give him time...
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Aug 16, 2019 4:05:13 GMT -7
Welcome to Dodgerslist, Meredith. So glad you’ve joined us all. We’ve got valuable information we’ve gleaned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you. **Disc disease is not a death sentence! ** Struggling with quality of life questions? Re-think things: www.dodgerslist.com/index/SDUNCANquality.htmYou have an emergency that must be dealt with ASAP this morning. There is no need for Tempo to be in pain. Pain meds have not yet been prescribed. Please contact your vet ASAP or an ER vet if your vet is not available and advocate strongly for the addition of pain meds. These are the meds usually prescribed for an IVDD episode - Tramadol as a general pain med, Methocarbamol for the pain of muscle spasms and Gabapentin for nerve pain. Pain hinders healing so have no patience with it. Pain should be completely under control within one hour of giving meds and should remain completely under control from one dose of pain meds to the next. Meloxicam works on getting the swelling pressing on the nerves down but that can take 7-30 days so pain meds are used until the swelling is gone. Usually a switch to Prednisone (steroid) from Meloxicam (NSAID) requires a 4-7 day washout period. However, if the vet feels that a switch to the more powerful anti-inflammatory, Prednisone, should be made, it can be done with the addition of TWO stomach protectors - both Pepcid AC and Sucralfate. Even if a switch to Prednisone is not done, please advocate strongly today for the addition of Pepcid AC. Anytime a dog is taking an anti-inflammatory, stomach protection must be added. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). canigivemydog.com/wp-content/uploads/2011/10/can-i-give-my-dog-pepcid-ac-300x300.jpg  Doxie weight dogs: 5mg Pepcid AC (famotidine) every 12 hours. NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory. www.1800petmeds.com/Famotidine-prod11171.htmlIt will help us work together with you and avoid offering ideas that could cause harm or lead the discussion in the wrong direction delaying help for your dog — please share a bit more detail with us: ❖1 For how many days has the Meloxicam been prescribed for? How many mgs in one ml?❖2 GI Tract problems? —Eating and drinking OK? No nausea/not eating, no vomit? —Poops OK? Normal firmness & color -no dark black or bright red blood indicating bleeding ulcers? No diarrhea? ❖3 The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those 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, the mattress and more! —> www.dodgerslist.com/literature/CrateRRP.htmSTRICT means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy whys: www.dodgerslist.com/literature/chiropractic.htm ◼︎no dragging or meandering at potty times. ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎At home laser or acupuncture for severe neuro damage is best. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. ❖4. Once Tempo's pain is brought under control, you should find it much easier to take him out to potty. At that point, you can determine whether he has lost bladder control or not. At that point, please let us know whether Tempo can specifically sniff and squat and then release urine which is bladder control – OR- do you find wet bedding or leaks on you when lifted which are indication of an overflowing bladder and loss of bladder control? Overflowing bladders need to be expressed to avoid UTIs. Review video then get a hands-on-top-of-your-hands expressing lesson. www.dodgerslist.com/literature/Expressing.htmDOGs with BLADDER CONTROL: 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  LARGE DOGS: If your dog is too big to carry, it is still important that the amount of movement to the potty place be minimized. Try a pee pad right outside the crate. Add caster wheels to a wire crate and wheel down ramp over steps to outside. ❖5 Currently can Tempo move the legs at all? or wag the tail when you specifically do some happy talk? It sounds as though he may be in too much pain for you to determine this. ❖6 Is the vet a general DVM or a specialist surgeon: ACVIM neurology or ACVS ortho? Knowledge is the power to fight the IVDD enemy and win!! The very best thing you can do for YOU, the caregiver, and for your dog is to get up to speed on IVDD soonest possible. Begin absorbing the must-have overall sense of meds, care and how the treatment works. Your dog will be depending on your ability to learn - excellent video series here: www.dodgerslist.com/literature/theater.htm PRINT OUT this link and tape to your fridge: www.dodgerslist.com/literature/healingpage.htm use the printout as your roadmap to avoid dangerous detours in your dog’s care make notes/highlight to keep yourself on track follow all the links in the next days to become the IVDD savvy pet parent your dog needs. Use the “search box” to easily locate topics over at our Main www.Dodgerslist.com website: www.dodgerslist.com/index/searchBOX.jpgNeuropathic pain is abnormal, phantom pain sensations with severe spinal cord damage. Signs are obsessive licking of paw, leg, genitals, tail. Escalates to biting, life-threatening chewing off parts. Immediately put on an e-collar (or lengthwise folded towel around neck and duct taped closed) to prevent access to lower body. Contact vet immediately for Gabapentin or stronger Lyrica (pregabalin) for neuropathic pain. More info: www.dodgerslist.com/literature/neuropathy.pdfIf there is great pain or severe neuro diminishment, acupuncture or laser light therapy can be be started right away as an adjunct to pain meds and to kick start nerve cell energy production. Options: Acupuncture vet who does home visits to avoid back moving during transports. For transport to necessary visits, pad out the recovery suite extra space with a rolled up towel/blanket to prevent body shifts during braking or cornering. CAUTIONS: ~~ Laser light therapy is contra-indicated with tumors which are detected via x-ray. ~~ During conservative treatment, anytime out of the recovery suite is a dangerous time for the healing disc. Movement of the back can increase a disc tear and escape of disc material into the spinal cord . For an animal with very mild neuro deficits, the risk of transporting to therapy has to be carefully weighed against what benefit is to be gained. www.ahvma.org/find-a-holistic-veterinarian/~~ Why Chiropractic is not recommended for IVDD dogs: www.dodgerslist.com/literature/chiropractic.htmPlease let us know what the vet says after speaking to them this morning. Healing prayers for Tempo.
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 16, 2019 5:11:22 GMT -7
Thank you for the reply.
1) Not sure-on the lable it says to give him .35ml (I am at work unable to answer that question) 2) No GI problems, he is eating, drinking, but peeing uncontrollable or we don't know. We are expressing him just so he doesn't get an infection. 3)He is in a top open crate with potty pads down and padding under. He also has a small pillow he loves to put his head on, it seemed to make him more comfortable. 4)He cannot move to potty-we were told not to even try to take him outside to eliminate. Last times we were taking him outside he was urinating on my clothes [loss of bladder control].
No ability to wag tail/stand/feet tucked under abdomen. 5)Back legs tucked-he has laid with them outstretched which seemed more comfortable but cant help him get into that position he has to do it himself. (I tried and he didnt like me helping) 6)Vet is a DMV that specializes on big farm animals over small animals, it is our only option and takes 6 hours of driving.
He showing signs of: Tembling Arched Back Panting off and on (stress or pain not sure) Head held up at an odd angle/propped against crate wall. (He even tries to sleep this way) Unable to move-If he tries it is very clumsy and hard to watch (this usually happens when he is trying to go #2)
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Aug 16, 2019 6:02:24 GMT -7
The vet who saw him on 8/14 will be able to look at his records and prescribe pain meds via a phone consult. Possibly he can fax or email the prescription(s) to a local pharmacy for you. However you can work it out, please get pain meds on board ASAP. Tempo will not be able to heal well nor will you be able to care for him well with him being in this much pain. Did the vet mention whether this was a neck injury? It does sound like a neck disc since he's holding his head up at an odd angle propped up. There are several things that you'll need to do to help a neck injury heal, such as softening hard kibble, raising food/water dishes, etc. More info here: www.dodgerslist.com/literature/cervical.htmIt doesn't sound as though Tempo has bladder control OR it may be that his inability to control it is due to pain. Peeing on your clothing when picked up means that the bladder was overflowing. How are you doing expressing him? Do you get a good stream or two each time you press on the bladder? How often are you expressing? Continue pressing on the bladder until you get just a dribble coming out and the bladder feels flat. It can take some practice to become proficient at expressing. Your goal is to express well enough and often enough so that Tempo remains dry in between expressing. More info on expressing here: www.dodgerslist.com/literature/cervical.htmWe'll be waiting for your response as to what pain meds and stomach protection the vet prescribes after you speak to him this morning.
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 16, 2019 7:03:23 GMT -7
Hi Margorie, Thank you again for your time.
We already spoke with the vet yesterday via phone to try and get other medicine, he said he would get it filled at the pharmacy here-but wanted to wait to let his meds kick in. (I can imagine his frustration with a client almost demanding a different treatment) Tempos head breeder told us about this site, and his direct breeder has been made aware of this site and the info and shes been on here reading about everything... We are all fighting this together and trying our best.
Him holding his head up- I am not sure if its a neck injury, but he does drink and eat with head down with no issues. The vet didnt suspect it, and hes never shown any signs of neck issues. He was doing it to get comfortable or something. He is on a soft diet of canned salmon, rice, veggies, with hemp supplement for inflammation.
Husband is doing all the expressing of his bladder, or we come to his crate with pee on the pads already. He has been getting a lot of pee out. I am "on it" about keeping him dry...I ordered some reuseable pads and have a box of pee pads...I am not too impressed with the pee pads.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 16, 2019 7:36:56 GMT -7
Meredith, you may have to step up in your advocating. Vet's who treat farm animals may not be fully comfortable in treating small animal IVDD.KEY to disc episode treatment is to RIGHT AWAY (TODAY) get the proper meds on board.Meloxicam, an anti-inflammatory, might be able to work in getting painful inflammation down. Hemp product not doing to do the trick. If actually aggressive pain meds are on on board and the pain still is not in control then, it would be a consideration to look at moving to the most powerful of the two classes of anti-inflammatory drugs (NSAIDs and steroids). Prednisone is the usual steroid chosen. Pain meds--- are needed at the get go right away, that should have been done on 8/14. Today, strongly advocate for a fax, a phone call in to your local town pharmacy for the three typical pain relievers. All have a short half life and would need to be Rx'd for every 8 hrs to provide round the clock pain relief 1) Tramadol for a 16 pound dog you would be looking for an Rx of a whole 50 mgs tramadol tablet given every 8 hrs. Many are way, way under medicating with this pain reliever. Reference for you to advocate for Tempo, not to self prescribe. 2) gabapentin for nerve pain. also every 8 hrs 3) methocarbamol for the pain from muscle contractions that are VERY typical to a neck disc. Also every 8 hrs. STOMACH protectionTake no chances. Poor Tempo has been subjected to no pain relief...a very big stress, Change in routine, a big stress. Meloxicam on top of those things is YET ANOTHER thing that increases stomach acids. Reread Marjories post to make sure Tempo has no health issues that his dose of Pepcid Ac might need to be adjusted. He needs Pepcid AC on board today! Pepcid AC (famotidine) blocks the production of acid. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours. Pepcid AC has a very limited potential for side effects. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). HEALTH ISSUES: “Mar Vista Vet reports: Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients.” marvistavet.com/famotidine.pml Meloxicam may take 7 to 30 days to "kick in" Underno circumstances does one let a dog be in pain til the anti-inflammatory can resolved all painful inflammation around the spinal cord. The three way combo of pain relievers is very typically this combo to start with: Tramadol as the general analgesic. A synthetic opiod gabapentin for nerve pain methocarbamol for the painful muscle contractions so often associated with a neck disc. Resources noting the efficacy of a mix of pain relievers being need to provide round the clock, dose to dose relief from pain while the anti-inflammatory may take in the range of 7 to 30 days to rid the body of all painful swelling/inflammation:
SIGNS OF PAIN reported about Tempo:
✔️ shivering-trembling ◻︎ yelping when picked up or moved ◻︎ slow to move ◻︎ tight tense tummy ✔️ arched back, ears pinned back ◻︎ restless ✔️ can't find a comfortable position (propped against crate wall to sleep this way) ◻︎ not their normal perky selves ◻︎ slow or reluctant to move much in crate such as shift positions pain specific to neck discs: ◻︎ looks up with just eyes and does not move head and neck easily. ◻︎ not eating due to painful chewing or in too much overall pain ◻︎ holds front or back leg flamingo style not wanting to bear weight ✔️ head held high or nose to the ground ( Head held up at an odd angle/propped against crate wall.) DIETHis soft diet is not one to stay on but a few days when trying to clear up loose stools, etc.. It is not balanced that his regular kibble diet is. Tempo has lots of repair jobs his body is working on and he needs a good diet. Soak his kibble in broth to soften it to become a soft food since he very, very likely has a neck disc. Will make it easier for him to eat. PROBLEM is you have changed his food and now you must gradually over the course of a couple of day transition him back to kibble food. Othewise he may have GI upset and then you dont' know if food caused it or the more serious that Meloxicam cause it. You may put a teaspoon or two of salmon on top of his soaked kibble for extra tastiness if that is needed.
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 16, 2019 9:08:54 GMT -7
So sorry, how bad did we mess up by not giving him pain meds from the start. He told me meloxicam was a form of pain reliever. Since we gave him meloxicam for a few doses, how do we go about switching them, besides buffering with the pepcid ac + Sucralfate to help his stomach. I think we were told to ask him for tramadol and prednizone...its written on my fridge. Sorry I am not familiar with these medicines.... So is this correct? Go to tramadol and prednizone with pepcid ac and sucralfate?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 16, 2019 9:52:54 GMT -7
The problem with a switch is that is does double jeopardy to the GI tract. Normally a 4-7 days washout is needed. But in a true emergency double stomach protection (Pepcid AC + sucralfate) is used and will likely avoid damage to the GI tract.
#1 thing NOW, today is to get pain meds on board + the must have Pepcid AC during the use of Meloxicam. If pain is then not fully in conrol THEN, you consider a switch to predniosne.
Do you have scripts in hand or now called into your local pharmacy so you can pick up the needed pain meds ( tramadol, gabapentin, methocarbamol)?
When the pain meds are correct, pain would be expected to be in full control dose to dose, round the clock. IF that were not to be the case THEN you and your vet would consider a switch to prednisone and take extra precaution of adding to the Pepcid AC you already have on board...adding sucralfate to the Pepcid AC to be able to switch from Meloxciam (a non steroid NSAID) to the steroid prednisone.
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 16, 2019 10:10:11 GMT -7
We had him fax the prescriptions, he didnt like the sound of tramidol, but we are switching to predizone. I told him about the pepsid ac and Sucralfate and he said it wasnt needed, as he hasnt had the ❌meldoxicam today, but i am going to give him pepsid ac anyways...give it time to coat his tummy. Give him food, then the new medicines?
What a mess...I hope we are doing the right thing.
[Moderator's note: please do not edit 16 lbs. Meloxicam as of 8/14: ?mg (0.35mL) 1x/day as of 8/15: ?mg ▲2x/day as of 8/16 STOPPED In pain but no pain meds on board! No stomach protection on board!]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 16, 2019 10:27:53 GMT -7
this vet is taking big bad risks with his medications for Tempo with his lack of GI protection and moving to prednisone. Is there any other vet you can see???? Dogs have died from bleeding ulcers when no protection has been provided! 1. Pepcid AC should be on board as long as YOU know he has no liver, kidney or heart issues that you read about in the quote I gave you from Mar Vista Vet on Pepcid AC. 2. Two stomach protectors are a must, a safety factor in this VERY risky business of switching to prednsoine 3. The emergency at hand this vet is not appreciating is to stay on meloxicam and get those pain meds in to Tempo body asap. THEN, then, when meds are on board and within an hour pain is not being brought into control dose to dose, round the clock.....THEN one would consider the RISKY BUSINESS of switching over to prednisone. The risk is greatly reduced by have two different GI protectors on board with the switch. --- SUCRALFATE - works to form a gel coating over any disrupted areas of the stomach lining --- Pepcid AC works in a different way to protect. It suppresses the production of stomach acids. Vets who know the dangers of switching NSAID to predisone:The antiulcer effect of famotidine plus magnesium and aluminum hydroxides [sucralfate] was greater than the sum of the effects of these drugs used separately.www.merckfrosst.ca/assets/en/pdf/products/PEPCID-PM_E.pdfMERCK CANADA INC. Date of Revision: April 27, 2011 ========= "Steroids should never be given concurrently with a non-steroidal anti-inflammatory. Over the years, I have been involved in several cases of both bleeding and also perforated gastric ulcers, some of which required transfusions and/or surgery. Many non-steroidal medications have a very narrow therapeutic dose and the addition of even one dose of steroids can lead to severe intestinal consequences. It is VERY important to look carefully at medication history before starting either a steroid or a NSAID." Beth Davidow, DVM, DACVECC "Steroid Rules to Live By" www.criticalcarevets.com/sites/default/files/RDVM_spring_woot.pdf========= When switching a patient from one NSAID to another (when no side effects have been seen), a washout period of 5 to 7 days minimizes chances for adverse drug interactions. Informing clients of the potential adverse effects of NSAID therapy and signs of NSAID toxicity greatly increases the likelihood of safe use of this class of drugs. Guidelines for safe and effective use of NSAIDs in dogs. Lascelles BD, McFarland JM, Swann H. Vet Ther 6:237-251, 2005. www.researchgate.net/profile/B_Duncan_X_Lascelles/publication/7468324_Guidelines_for_safe_and_effective_use_of_NSAIDs_in_dogs/links/02e7e5166e788375a7000000.pdf======= "NSAIDs have significant drug interactions with glucocorticoids (gastrointestinal ulceration is potentiated by glucocorticoids via inhibition of prostaglandin synthesis), benzodiazepines, salicylate containing herbs (meadowsweet or willow), gingko, garlic, ginger, ginseng, and aminoglycosides. ... Consider a minimum of a 7-day washout period between NSAIDs and either glucocorticoids or other NSAIDs." SMALL ANIMAL PAIN MANAGEMENT CLINICAL PHARMACOLOGY Katrina R. Viviano, PhD, DVM secure.aahanet.org/eweb/images/AAHAnet/phoenix2009proceedings/pdfs/01_scientific/025_SMALL%20ANIMAL%20PAIN%20MANAG.pdfPublished uses of GI tract protection The antiulcer effect of famotidine plus magnesium and aluminum hydroxides [sucralfate] was greater than the sum of the effects of these drugs used separately. www.merckfrosst.ca/assets/en/pdf/products/PEPCID-PM_E.pdfMERCK CANADA INC. Date of Revision: April 27, 2011 ===== 3) Colin F. Burrows, B.Vet.Med., PhD, MRCVS, DACVIM College of Veterinary Medicine, University of Florida Gainesville, FL, USA 2003 There are nevertheless, certain fundamental principles that must be applied to all patients. ... protection of the gastric mucosal barrier... This can be minimized with aggressive prophylactic therapy early in the disease process. Intravenous ranitidine is a good initial choice with an oral proton pump inhibitor in severe disease. Oral sucralfate is also beneficial since it forms a protective shield over the eroded mucosa.www.vin.com/proceedings/===== 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats* 8. Use gastroprotectants to either treat suspected gastropathy or prevent its occurrence, especially if no washout period occurs. Proton pump inhibitors, H2 antagonists [famotidine], misoprostol (the drug of choice in humans), and sucralfate can be helpful. www.animalsurgical.com/wp-content/uploads/pain-management.pdf===== For symptomatic animals, GI protectants are very important. Mild gastrointestinal irritation may be treated symptomatically with antacids, such as magnesium or aluminum hydroxide. Misoprostol is helpful for treating or preventing gastric ulceration caused by NSAIDS as it stimulates mucus and bicarbonate secretion and increases gastric mucosal blood flow (contraindicated during pregnancy due to its abortifacient activity). H2 blockers [famotidine], sucralfate and omeprazole can also be used to manage and/or prevent gastric ulcers. Sharon Gwaltney-Brant, DVM, PhD, DABVT, DABT. Toxicity of pain medications (Proceedings). 2010. veterinarycalendar.dvm360.com/toxicity-pain-medications-proceedings-0 Meredith, please let us know that you were sucessful in presenting a good advocacy case about your deep concerns for the safety of Tempo's life with a switch to pred without TWO (2) GI tract protectors on board.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 16, 2019 10:33:57 GMT -7
What are the details about the pain meds Rx'd he faxed over?
Name of each med? # of mgs for each dose? How many times a day to give each med?
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 16, 2019 14:57:38 GMT -7
OK! What we have now is 5MG of PREDNISONE with the instructions: 2 tablets each day for 10 days, then 1 tablet per day for 10 days then give 1 tablet every other day till finished AND 100MG of GABAPENTIN with instructions: Give 1 capsule twice a day.
Reading up on GABAPENTIN, it says NOT to give antacid 2 hours prior to giving because it effects the drug on a blood level.
[Moderator's note: please do not edit 16 lbs. Meloxicam as of 8/14: ?mg (0.35mL) 1x/day as of 8/15: ?mg ▲2x/day as of 8/16 STOPPED
DANGER: Prednisone RX'd as of 8/16 with no 5-7 washout no double GI protection!!!
✙Gabapentin 100mgs 2x/day (undermedicated for a 16lbs dog in severe pain) Pepcid AC (famtoidine) 5mgs 2x/day]
I have the pepcid AC original strength (we couldnt find it...but finally did...)
At this point I am a bit confused as to what to do...
Give pepcid ac 20min prior, and then food, then meloxican + gabapentin?
I think we do need to change over to the Predinisone considering his condition but unsure how to go about this. I dont want to give meloxican anymore if it is an issue weening off it.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 16, 2019 15:35:11 GMT -7
Do not give meloxicam and prednisone together. There is supposed to be a 5-7 days stoppping of meloxicam BEORE prednisone starts. You do not have the 2nd GI protector on board- sucralfate. So really since you can't get a vet to RX sucralfate and double protect the GI tract, it is far safer to continue with meloxicam (no pred) and get proper pain meds on board.So until you can get sucralfate, it is a danger to start the steroid prednisone. Far safer to stick with meloxicam and proper pain meds. Pepcid AC 5mgs of famotidine every 12 hours. Start right away. It is effective for 12 hrs. AGAIN- advocate for pain meds (gabapentin to be RX'd for every 8 hrs. 2x/day is no where near good enough. If you read enough of the threads, you will see that pretty much the vets are not concerned with the 2 hr anti-acid thing. Important thing is to get that pain in control. Meridith the pain med Rx of only one (gabapentin) AND twice a day is WAY, WAY undermediated for a disc episode and the pain Tempo is in. needs plus: Tramadol or another general analgesic every 8 hrs needs plus: methocarbamol for the pain of muscle contractions every 8 hrs. Prednisone will not give immedate pain relief. It may take 7- 30 days before it can get the inflammation down. Do you want Tempo to be suffering til then. NO WAY. That is what pain med are for. They act in one hour: tramadol, gabapentin, methocarbamol --- all should be Rx for every 8 hrs. D/l and print from here: www.dodgerslist.com/literature/crateRRP/medchart.pdf
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Post by Romy & Frankie on Aug 16, 2019 15:37:31 GMT -7
Please do not give any more meloxicam if you are giving pred. It is very dangerous to have an NSAID (meloxicam) and a steroid (prednisone) in the body at the same time. Pepcid AC is an excellent stomach protector but in the situation where there has not been 5 -7 days between stopping one type of med and starting the other (this is called a washout) an additional medication is needed. This is sucralfate. Please strongly advocate for this to be added. Politely but persistently explain that you are concerned about stomach damage. Do not wait until signs of stomach damage appear. Dogs cannot speak up like a person would if they are feeling nauseous or have heartburn. It is only when we see diarrhea or a refusal to eat and drink that we realize something is wrong. By that point stomach damage is likely to have already started.
The dose of Pepcid should be 5mg. If the tablet is 10mg cut it in half. Give it 30 minutes before the pred. Then give it every 12 hours as long as Tempo is on the pred. Give the gabapentin every 12 hours. Timing with the pred is not neccessary with gabapentin but there are some vets that say Pepcid slows absorption of Gabapentin so you may want to give it an hour or so before the Pepcid AC.
I hope that gabapentin 2x a day will keep Tempo's pain in control. Gabapentin does not last long in the body and may need to be given three times a day to provide relief. IVDD is typically painful and additional medications may be needed. If Tempo shows signs of pain speak to the vet right away about adding Methocarbamol for painful muscle contractions and Tramadol Rx'd 3x/day as the general pain reliever.
Please let us know that Tempo's pain is under control and you have been able to get the sucralfate.
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 16, 2019 17:52:58 GMT -7
I am not sure what to do or say. I have called my vet 5 times talking to him, he gave me the meds yall have suggested. What am I suppose to say to him, some forum online is telling me to do differently?
I have:
The pepcid AC. Meloxican, Prednisone and Gabapentin.
He has NOT had the two meloxican with Prednisone I know not do mix directly. But the Vet wants a direct change over-knowing there is a slight break, and he said the amount he was on was very little.
He has been OFF meloxican since yesterday (8-15-2019) at 9PM.
Vet instructed to not give Pepcid AC. Give first dose of PREDNISONE tomorrow morning (8/17/2019) with food.
He had his first dose of GABAPENTIN this afternoon 8/16/2019.
Right now he is laying on his side in the box, I put 10 layers of dog pads down so we can just pull up the soiled ones, bolsters of rolled up towels so he is even more confined.
Reading up on Gabapentin 100mg is enough for seizuring animals, something like 10mg is for pain, so giving the 100mg to help him seems realistic.
I am not sure of everyone's a) experience or b) expertise/qualifications to give doubt to a vets directions. I do understand yall are trying to help. I am trying my best right now.
If I give the pepcid AC it does effect the GABAPENTIN on some level, or it wouldnt be published on the drugs information.
Saying that, I DO want to do everything to prevent him from getting something wrong with his stomach.
My PLAN for tomorrow morning (8-17-2019) is to wake up at 3-4AM give him the Pepsid AC, husband will give him food+prednisone AND gabapentin 3 hours later. Even in doing this we are "going against the vets advice"
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 16, 2019 18:18:55 GMT -7
I have provided you with quotes from neuro surgeons and other in the know entieies about IVDD regarding the severe danger of using a steroid without first stopping the meloxican fora 5-7 day washout. When it is deemed a real authentic emergency of loosing neuro functions (severe spinal cord damage) or after an actual aggressive use of pain med the pain is not getting in contol, THEN IVDD knowledege vets will make the decision it is an emergency and forgo the normal 5-7 days of washout. Instead knowing there will be double jeopardy to the GI tract of bleeding ulcers, they double protect with both sucralfate and Pepcid AC. I do not know about horses and cows and other large animals and GI tract damage. I do know with my readings of veterinary literature and tragically watching here on the Forum vets who do not appreciate the deadly damage of bleeding ulcers can do when they've not protected the stomach lining. Your vet does not know the the damage he can do to a small animal, dachshund, by Rxing Prednisone with no double GI tract protection. The reason for a 5-7 days washout is because EVEN ONE dose takes 5-7 days to leave the body. Each dog's metabolism can be different and the reason for giving a range of how long it may take meloxicam to leave the body and thus not to have both Meloxicam in the middle of leaving the body while starting a pred dose. More professionals' quotes Getting quickly up to speed on IVDD is how you protect your dog from those who do not know IVDD. Whilst you are reading, we are trying to shortcut your studies by explaining issues and substantiating with quotes from professionals. We do not want you to just take our word but take the word of knowledgeable IVDD vets to save your dog from possible tragic results.
Not all vets know IVDD. Impossible for them to know all the disease of every large animal, farm animal and all small animals, cats, dogs, birds, and all the breeds for each. But you can know just one disease and be able to share what you learned with your vet.STRATEGYCan you be up front with your vet. Tell him all the vet professionals who deal with NSAIDs and steroids are publishing the same thing. YOu are very concerned:-- not wanting to use prednisone unless the stomach can be double protected with an Rx from him for sucralfate and you having Pepcid AC from the grocery store.-- concerned with the pause in meloxicam that pain would naturally likely sky rocket with no anti-inflammatory on board. -- concerned there is not a three way cocktail of pain meds each addressing the typical types of pain that comes with a disc episode. Whether he stays on meloxicam or eventually goes to pred when double protected, the meds need to cover each kind of pain: ~Tramadol or another general analgesic ~ gabapentin for nerve pain with a disc episode. Gabapentin has other uses at other mgs doses/frequency which may not relate to what is needed with a disc episode. ~methocarbamol for the pain of muscle contractions. All three of above pain meds have a short half life. That means they do not stay up at a useful level in the body very long and thus why the are normal Rx'd for 3x/day (every 8 hrs.)Who is Dodgerlists?...vet us, too please: www.dodgerslist.com/index/education.htm
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 16, 2019 18:53:00 GMT -7
Another bit of concern is if we do the first dose of the dreaded Prednisone tomorrow, as instructed by the vet, would be a double dose of 2 pills (5mg x 2= 10mg).
I do have concern with that as everything I am reading is leaning towards something going wrong with his GI.
This is our 3 choices husband and I are debating.
Stay on MELOXICAM + PEPCID AC + GABAPENTIN and just go with that.
STOP MELOXICAM FOR 4-5 DAYS WASHOUT, start on PREDISONE but keep GABAPENTIN going.
DRASTIC SWITCH to PREDISONE x 5mg pills + PEPCID AC hours before to coat, and GABAPENTIN with FOOD.
We are really having a hard time and its not an easy decision for us, especially with Vet orders saying "do it its fine"
Tempo was sleeping and I grabbed his back paw and got him to wake up from touching him only, so we do think we have feeling in the feet. He is no longer shivering, but is laying down and sleeping. If he sits up he tucks his feet under him and is awkward shuffling his rear around.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 16, 2019 19:04:02 GMT -7
GABAPENTIN and warning with metal salt antiacid products“Avoid taking aluminum or magnesium containing products (such as antacids) for 2 hours before your gabapentin. “ www.webmd.com/drugs/2/drug-56489/antacid-with-simethicone-oral/details/list-interaction-details/dmid-1207/dmtitle-aluminum-magnesium-containing-compounds-gabapentin/intrtype-drugNOTE: Pepcid AC is not a aluminum or magnesium metal containing antiacid. Pepcid AC (famotidine) is actually an antihistamine. Pepcid AC does not coat the stomach lining! www.marvistavet.com/famotidine.pmlPREDNISONE IF, if his stomach were protected by both sucralfate and Pepcid AC, then taking 5mgs of prednisone 2x/day would be the anti-inflammatory dose that is required with a disc episode. So if Temp is not going to be protected, there should be no switch. PAIN MEDS are the keyWhat should happen is that pain meds NEED to be on board in the right dose and given every 8 hrs. You need to address and successfully advocate this very real concern of getting pain in control. Pain hinders the whole healing process. The same aggressive pain med approach would be used whether staying in Meloxicam or with d ouble stomach protection + prednsione. -KEY is working on the pain meds. -The KEY is not moving to a different anti-inflammatory (pred). -Both Meloxicam and pred may take up to 30 days to resolve pain. -AGAIN the KEY is getting pain in control now, today, not in the 7-30 days ANY anti-inflammatory will take to get all painful swelling/inflammation resolved.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 16, 2019 19:14:32 GMT -7
A washout means there is nothing at the necessary level to be working on inflammation. EXPECT for pain to then rise. That means perhaps even stronger pain meds protocal than what I had listed out for you to advocate for. Your best bet and less pain/danger for Tempo is the "Stay on Meloxicam. Advocate for gabapentin every 8 hrs, Advocate for methocarbamol every 8 hrs. Advocate for tramadol or other general analgesic every 8 hrs. EVERY 8 HOURS is the typical for pain meds to be prescribed. SCroll though the Conservative board... the each dog's med list is there for all to read! Go over and read what an IVDD knowledge surgeon has prescribed when he goes from Meloxicam to prednisone without a washout. It is sucralfate and Pepcid AC!!! This surgeon is also in Canada, the difference is he knows IVDD!!! Jaclynn's Willow Med list dodgerslist.boards.net/thread/7031/jaclynns-willow-surgery-victoria-canada 7.3 kg/ 16.09 lbs Meloxicam stopped on date? name of Steroid started w/o 5-7 days washout name of pain medications? Double GI protection with switch from Meloxicam to steroid sucralfate Pepcid AC (famotidine)]
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Aug 16, 2019 21:01:51 GMT -7
Meredith, I agree with Paula. IF you can get BOTH Pepcid Ac and Sucralfate on board, then a switch can be made from Meloxicam to Prednisone. If only Pepcid AC is on board, then no switch should be made.
When there's mild pain, sometimes a dog's pain can be brought under control with one pain med. Tempo's pain is not mild but rather severe and aggressive pain meds are needed so he can rest in comfort. Tramdol, Methocarbamol and Gabapentin are what vets who understand how severe IVDD is will prescribe.
From what you've told us, Tempo has been in great pain, in too much pain to be picked up and carried out to potty, in too much pain to even move. And yet your vet prescribed no pain meds until you advocated for them. You're the captain of Tempo's medical team. You hired your vet to care for Tempo. When you have questions due to knowledge that you've gained from reading about IVDD, you have every right to discuss those issues with your vet and keep discussing those issues until you're satisfied with the answers you're getting. What we do here on Dodgerslist is educate what treatment works for IVDD. Many vets are open to learn about IVDD as they may not have come across many cases of it.
The advice given here is based on consultations with Board-certified vets and also what we've seen here on the forum with the many thousands of dogs that have passed through. We've learned over many years what works and what doesn't and what is dangerous and how to prevent dangers. So Dodgerslist is not just some unknown group on the internet but rather a respected source of information about IVDD.
The reason I became a moderator here on Dodgerslist is because I was given wrong information by a vet when my Jeremy was first diagnosed with IVDD. I was not told about strict crate rest and my Jeremy paid the price with total paralysis and permanent loss of bladder/bowel control. I wish I had known enough then to question wrong advice given by a vet. But eight years later, I've learned a great deal and that's what you're doing now, learning and questioning and advocating for your dog who cannot speak for himself. It's a learning curve that all of us here have gone through. We don't want to see Tempo or any dog suffer from wrong advice.
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Post by Pauliana on Aug 16, 2019 21:27:14 GMT -7
Hi Meredith,
Paula has been giving you the right info in regards to not doing a switch to Prednisone without double protecting the stomach..This kind of a switch can kill.. Bleelding ulcers and perforated stomach lining can kill.. Pepcid AC protects from acid that anti inflammatories cause.. Pepcid AC is not like tums or rolaids, that interfere with Gabapentin.. Pepcid AC is a H2 blocker that is actually an antihistamine.. It can be given with Gabapentin.. Sucralfate gel coats the stomach and heals damage.. A vet that would not give double stomach protection is not the Vet that should be treating your Tempo...
My Tyler has had IVDD since 2013 and he has always been treated with a NSAID such as Metacam once a day and Tramadol and Gabapentin 3x times a day when he has an episode...He has always taken Pepcid AC 30 minutes prior to Metacam until a couple days after the Metacam has been stopped.. He is usually on meds for about 7 to 10 days until the swelling has gone down.. He has a great Vet that knows this disease and she has experience in treating it.. Thankfully he has not had an episode in about 2 years and is active and happy at almost 10 years old.. I never had to double protect his stomach because he stayed on Metacam (Meloxicam) for his treatment.. But if he would ever have to switch to a steroid, his stomach would be double protected and his great Vet knows to do so.. I would keep Tempo on the Meloxicam and Gabapentin and if pain isn't in control ask for another pain reliever.. such as Tramadol.. I wouldn't give Prednisone without Pepcid AC and Sucralfate on board..
I know how traumatic IVDD Tyler has been living with it for years but the best thing to do is to find a Vet that will work with you and not argue against the right treatment...
Wishing for better days for you... Listen to Paula, she knows this disease.. Marjorie and Romy do too! Dodgerslist has been in existence since 2002.. We know this disease as we all have dogs with it and we have thousands of members that have been helped here.... We also have expert Vets that advise us.... I know when Tyler had his first episode in 2013 and woke up paralyzed I was in total panic mode and it was Dodgerslist and his Vet that helped teach us how to care for Tyler... He recovered walking.. and continues to be an active and playful dog..
Healing thoughts and prayers..
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 17, 2019 2:30:04 GMT -7
Good morning,
We gave him the first dose of Gabapentin last night 8/16/2019 and it totally knocked him out. This morning at 3am he was still zonked.
Husband is going to call the vet at 9am 8/17/2019 and question him on the sulcrafate again, if he still doesnt want to give it to him, we will do meloxicam +pepcid ac+ gabapentin + food...
If I could just grab the sulcrafate off the shelf and do it then wouldnt be a problem. We do not have another vet to go to, as we are super remote.
Thanks again guys for all the support. Again, the vet does not want to give any more meds over the ones we have to work with. And he absolutely refused to think about Tramadol. His words was "it doesn't work well in dogs". You can imagine our frustration, getting mixed messages, and a vet that is standing his ground.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 17, 2019 5:45:50 GMT -7
Meredith, good, sensible plan you have based on what the vet says.
Yes, there is now discussion that tramadol is not as effective as once thought. Maybe that is the case for many or some dogs. But then why do we still see neuros still prescribing as well as many DVMs? Why do we see when tramadol has been added to the cocktail mix finally the dog is out of pain. So it may work for some dogs when it is used at the "max analgesic" dose. Owners are reporting their med lists on this Forum. What we see is that many vets are Rxing a very, very low dose of tramadol, not every 8 hrs and thus tramadol is doing didly squat. We comment to the owner about advocating for the max analgesic dose 3x/day and voila the dog is out of pain.
Finding the right combo of pain meds and the right dose in mgs may take adjusting things. IF gabapentin has him sleeping and out of pain that is not a bad thing. Sleep is healing. Discuss with the vet about tweaking the gabapentin to a dose that can be given every 8 hrs. This way he can be awake to take meds, you can care for his expressing needs and still be out of pain. A combo of meds (gabapentin for nerve pain, methocarbamol for muscle spasm pain associated with a disc episode and tramadol or another general analgesic) can mean an animal out of pain and not zoombied out. For instance my 17 lb doxie took 33mgs of gabapentin 3x/day, 50 mgs of tramadol 3x/day and 125mgs of methocarbamol 3x/day and was pain free. Pain meds have a range in mg dose...so there is the possiblity to adjust up or down to get it just right for a particular dog. Feedback to the vet on signs of pain, being too zonked out, etc allows the vet to adjust meds.
FYI, prednisone will cause increased thirst and necessarily filling up the bladder more often. That would mean expressing the bladder every 3-4 hrs while on prednisone. How are you doing with expressing. Does his bedding stay dry session to session. How often are you expressing?
Please keep us updated when Tempo awakes about if he displays any pain signs nearing the next dose of gabapentin.
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 17, 2019 6:26:58 GMT -7
Thanks Paula, this has been an exhausting few days. My husband slept on the couch last night with his hand in Tempos crate/pin...Tempo is my husbands heart dog...and this is tearing him up.
I have a friend in Alberquerque that wrote to me this info which made me shy away from Prednisone esp without the 2 stomach protectors:
A. Tramadol does not treat pain, but it alters the way the body perceives pain and is often used in conjunction with another drug or as an additional pain management strategy for chronic conditions. It is a class 4 controlled substance.
B. Prednisone mimics the hormone cortisol. Although it reduces inflammation, it also suppresses the immune system, inhibits healing, alters mood, stimulates appetite, increases gastric acid, weakens muscles, thins the skin. Can also cause liver problems.
C. Meloxicam reduces pain, inflammation and stiffness by reducing hormones that cause pain and inflammation.
She also advised to calm down and let the medicine try to work, so we can see what it is doing instead of switching/adding in a frenzy. It really seems like the gabapentin made a huge and fast difference- I am very glad we pushed for a pain killer. On the vet's side of things Tempo when we saw the vet was not fully crashed, he was still able to shuffle/walk somewhat and was hunched over, where as now I consider him fully crashed with legs useless...
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 17, 2019 6:34:44 GMT -7
All anti-inflammatories (NSAIDs like Meloxicam and steroids) have their adverse side effects. When needed to protect the spinal cord by getting swelling down, they are a god send. So the risk vs the benefit is one to take advantage of for the short time a disc episode dog would be on them vs. dogs with arthritis who may be on a daily life time therpy. The key to using either a NSAID or a steroid is using them in a safe way and knowing when it is a true emergency to consider a switch to a steroid. What trusting eyes our dogs have! Vets choose an anti-inflammatory during a disc episode to get painful swelling down in about 7-30 days. These powerhouse meds do wonders OR they can be dangerous. Vets who practice safe medicine and owners up to speed on medications make all the difference. Did you get all four questions right?
From our Neuro Corner, Dr. Isaacs and Galle, Neurology (ACVIM) address the use of anti-inflammatory drugs: Kögel B1, Terlinden R, Schneider J. Characterisation of tramadol, morphine and tapentadol in an acute pain model in Beagle dogs.Vet Anaesth Analg. 2014 May;41(3):297-304. doi: 10.1111/vaa.12140. Epub 2014 Feb 27. www.ncbi.nlm.nih.gov/pubmed/24576316CONCLUSIONS AND CLINICAL RELEVANCE: Measurements of the serum levels of tramadol and the M1 metabolite revealed only marginal amounts of the M1 metabolite, which explains the absence of the antinociceptive effect of tramadol in this experimental pain model in dogs. Different breeds of dogs might not or only poorly respond to treatment with tramadol due to low metabolism of the drug. Tapentadol and morphine which act directly on μ-opioid receptors without the need for metabolic activation are demonstrated to induce potent antinociception in the experimental model used and should also provide a reliable pain management in the clinical situation. The non-opioid mechanisms of tramadol do not provide antinociception in this experimental setting. This contrasts to many clinical situations described in the literature, where tramadol appears to provide useful analgesia in dogs for post-operative pain relief and in more chronically pain states. Veterinary pharmacist: Veterinary pharmacologist Bruce KuKanich, DVM, PhD, DACVCP writes: "Tramadol is rapidly eliminated from dogs after oral administration. Recent studies are suggestive the bioavailability of tramadol in dogs is lower than originally determined and the dose of tramadol needs to be increased with dosages from 5 - 10 mg/kg PO q 8-12 hours in dogs to maintain similar plasma drug concentrations as those in humans." New developments in opioids: old drugs and some future directions (Proceedings)" DVM360. Nov 01, 2009 veterinarycalendar.dvm360.com/new-developments-opioids-old-drugs-and-some-future-directions-proceedings Last accessed 3/18/16 One thing to never calm down about is pain. There is no excuse for not using pain meds. Switching to a steroid when Meloxicam OR a steroid might take 7-30 days to resolve pain makes no sense in light that the vet never Rx'd a pain med at the vet start of Meloxicam. Tempo would just as likely been in pain if the vet has only used prednisone. Keep in mind, the job of pred or of meloxicam is not to heal the nerves but more to prevent futher damage to the spinal cord caused by swelling. Nerve healing is something the body will do in time. Might be best to think in terms of months rather than days/week for nerve healing. Nerve healing may or may not take place in the short time of 8 weeks it takes a disc to heal. Is your friend in a medical field? a pharmacist?
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 17, 2019 17:43:09 GMT -7
Puked 8/17/2019 small amount morning. After all medicine + food approx. 2 hours later. Puked 8/17/2019 small amount. evening. Directly after Pepcid and Food, before RX medicine was given.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 17, 2019 17:55:51 GMT -7
Meredith, a small number of dogs may experience an uncommon side effect of Pepcid AC (famotidine) of vomiting. It that is the case for Tempo, then moving to a different kind of acid suppressor would be the thing to do. This class of acid reducers is called proton pump inhibitors (PPIs). Dose 30 mins before giving anti-inflammatory and thereafter every 12 hrs. (2x/day) Brand name Prilosec (omeprazole) is available from the grocery store shelves. Read over the Mar Vista entry for omeprazole and confirm with your vet Tempo has no health issues to prevent using: www.marvistavet.com/omeprazole.pml NOTE: Omeprazole will take 3-5 days to reach peak efficiency and then it supposed to be better than Pepcid AC. With a disc episode, waiting for 3-5 days is not the best idea and why Pepcid AC get best recommendation.
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 18, 2019 3:10:23 GMT -7
Called the vet 8pm 8/17/2019 to report the vomiting. I was concerned he puked up his pain medicine.
He basically said at this point Tempo is what he is/where he is-that he is in state of perm paralyzed and that if we did want to do something to fix it, the surgery would have been what we needed to do.
I tried calling my main breeder who wasnt available.
Called a breeder in BC who has been in dachshunds for 30+ years. Talked to her for a while.
She suggested I ask for a form of Chondroitin shot (I wrote it down on our fridge-but the specific name alludes me right now) that I can administer to help.
I also said he hasn't had a real BM (#2) and I felt he was constipated. She suggested I add pumpkin to his food.
She said everything we were doing sounded right, and to keep on it. We will see if the Pepcid AC causes vomiting today, maybe it was something else.
She asked if since he puked right after the pill if we VISIBLY saw the pill in the puke, we did not, so she thinks it still was in his belly.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Aug 18, 2019 4:41:29 GMT -7
No one, absolutely no one, can tell you whether Tempo's paralysis is permanent or not. Nerves can take a very long time to heal, months, even a year or more, but heal they can. And surgery is not the only treatment for IVDD. We've seen many, many dogs here on Dodgerslist heal from paralysis with conservative care and we've seen many, many dogs surprise their vets and walk again. So please don't take the vet's words to heart and do stay positive. Tell Tempo every day that he's getting better and you believe it, too.
When my Jeremy first went down with IVDD 8 years ago and was paralyzed, losing deep pain sensation, he wasn't walking three months after and I was told that he would never walk again. Three months after I was told that, he was walking.
Yes, the meds can cause constipation and pumpkin is very good for that. Give one teaspoon of pumpkin for every 10 pounds of body weight per day. To loosen the stool, add equal parts water to each kibble meal along with plain canned pureed pumpkin 1x a day. Note alternatives for constipation: really ripe mashed fresh pear, just take off the peel; microwaved and mashed peeled sweet potato.
I'm not familiar with Chondroitin injections. Mainly we see members giving that as a supplement. It can be helpful for the pain and inflammation of arthritis. What Tempo needs right now are the big gun meds, which you are giving him. The Meloxicam is working on reducing the swelling and the pain meds are to mask the pain until the swelling is gone. If there is still pain, then pain meds need to be adjusted. The strict crate rest will heal the damaged disc. The only thing that will heal the nerve damage is time and the body's self-healing.
Do you currently feel that all pain is now completely under control from one dose of pain meds to the next, with no pain arising at any time?
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Meredith & Tempo
New Member
Male - Doxie -Lost battle 8/22/2019 from Myelomalacia
Posts: 38
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Post by Meredith & Tempo on Aug 18, 2019 7:09:15 GMT -7
Good Morning,
Husband called to report he had vomited the pepcid ac, and there was a bit of bright blood in the puke.
This was going on this morning between now and my last post.
We are figuring all his vomiting is from the constipation. I had noticed he had not been doing #2 at all for too long of a time. I told hubby that he hadnt #2ed and I was concerned...all of this inbetween trying to decide what treatment and calling vets/breeders...reading stuff on here...we "messed up" and didnt treat the constipation in time and probably is the reason of vomiting the pepcid ac. So this mornings events:
Pepcid AC 5-6am Vomiting 6am-7am Pumpkin+Food 7am-8am
Waiting to see if he holds down this food and if we can get a #2 before retrying the Pepcid AC (He threw up the whole tablet) and then the meloxicam and gabapentin to be administered in the next hour or 2.
This has been a catastrophe with the constipation not being addressed.
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