bart
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Post by bart on Mar 16, 2013 0:19:02 GMT -7
--What is your dog's name? Lola
--What breed is your dog and did you specifically get a diagnosis of IVDD? She is a Doxie and yes I did. But no MRI's or X-rays
-- What was the date you saw the vet and started 100% STRICT crate rest 24/7? 2/17/2013
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Is there still currently pain - shivering, trembling, yelping when
picked up or moved, reluctant/slow to move head or body, tight hard
tummy? For the first few weeks she was doing really well. We even had one day after acupuncture that her back paws didn't "knuckle" But unfortunately they are back to doing that again. Today was a set back. She started feeling pain and yelping when I try and take her out of the cage to go to the bathroom. I am not sure what happened. She was having a really hard time getting comfortable tonight. I hate seeing her in pain like that. I am staying on top of her meds for the past few weeks and she is on STRICT crate rest 24/7.
-- What are the exact names of meds currently given, their doses in mgs and frequencies? She got one round of steroids for the first 7 days. Now she is on Rimydal every 12 hours and Tramadol 50mg every 8 hrs. I give her 5mg Pepcid AC 30 min before giving her morning dose of meds but I don't do it again at night. Should I be giving her more? Also with the pain starting up again should I ask the Vet for another round of steroids? She is getting Acupuncture once a week right now. We go back for the 3rd week tomorrow.
-- Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk? She can stand in one place for a few seconds then flops over to one side on her butt. She can move her legs when she is laying down in the crate when I pet her belly. And she wags her tail every time I talk to her when she is out of the crate.
-- Do you find wet bedding or leaks on you when lifted up? Occasionally I find a little bed wetting but for the most part when I take her out of the crate she goes pee and poop all on her own
-- Eating and drinking OK? She was eating great until about a day or do ago. Now it seems she is having to be coaxed to eat. I have to put a few pieces in my hand then she starts to eat. I stopped feeding her out of the bowl cause it seemed she didn't like that but now even the plate she isn't liking. She seems to be drinking ok but not super great. But she never really drank a lot of water before either.
-- Poops OK - normal color no dark or bright red blood? Poops are good 
Thank you for this website and the threads!!!
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Mar 16, 2013 8:48:43 GMT -7
Bart, welcome to Dodgerslist! We are very glad to see you. Thank you for taking the time to answer our questions to give Lola's concise status. The last date of steroids was on 2/24 then? And how many days after did she start Rimadyl? Vets who practice safe medicine will look for a 4-7 day washout from the one class of anti-inflammatory (steroids) to the other (NSAIDs) to avoid a very dangerous reaction of bleeding ulcers or worse of a perforated stomach lining. Why....what was the reason for a switch at all? Was she displaying GI tract issues of vomit, diarrhea, blood in the stools? As per the FDA and NSAID, Rimadyl package insert... red flags of any one is enough to STOP the NSAID and get vet help. www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm196295.htm or snipurl.com/2348157Lola needs your prompt help asap. Give pecpid ac 2x a day as it only lasts for a bout 12 hours. Get with the vet and let him now the signs of not eating/ drinking. Advocate strongly to get a 2nd stomach protector on board asap. Sucralfate works to coat damaged areas and Pepcid works to reduce acid production. As always know each med your dog takes so you understand how the meds is to work, adverse side effects and what to do if you see them. This is a wonderful alpha directory I use all the time: www.marvistavet.com/html/pharmacy_center.htmlWould surgery be an option for your family if neuro functions diminish to loss of bladder control and happy tail wagging? It is problematic to switch back to the most effective of anti-inflammatories, a steroid. With a washout of 4-7 days she'd have nothing on board to reduce swelling. Knuckling is nerve damage from the swelling and a step backwards for Lola. YOu have to have a serious conversation about a switch with your vet, the dangers to her stomach since she is already showing adverse signs from Rimadyl with not eating. Discuss her pain meds as well, they are no longer covering pain properly. These are the typical meds prescribed for a disc episode. Tramadol - a pain reliever that usually is prescribed every 8 hours to give full pain coverage Methocarbamol - pain relief from muscle spasms. Usually prescribed 2 or 3 times a day Gabapentin - is add to the above two WHEN there is hard to control pain We are worried and would like to hear back on your success in getting sucralfate on board and the pain med adjustments to get her pain back under control. When pain meds are right pain will be controlled in an hour and thereafter dose to dose. |
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bart
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Post by bart on Mar 16, 2013 23:40:26 GMT -7
Thank you so much for the quick reply. Unfortunately I saw this after I went to the vet but definitely glad I saw this before I gave her the steroid. The original time she was on the steroid for 7 days I did a wash out of 4 days. Why she didn't stay on it I have no idea. They just put her on the Rimadyl after the steroid. Needless to say it is frustrating working with vets that don't really specialize in this specific breed. I have learned more form this list than from my vet. I tried researching for a vet that specializes in the Doxies but I can't find anywhere.
Lola is eating but she is being weird about her eating habit. She is making me feed her. I think it's because she is in pain. As soon as I put it in my hand she eats it right up. I did see her drinking from her bowl in her cage this morning so that made me feel better that she does drink from that bowl. Now I am taking the bowl and offering her water and most of the time she will drink some water out of it.
I did get another order of steroids for her. They have me giving her [Pred] 1/2 tab every 12hrs for 7 days then 1/2 tab every 24 hours for 14 days. And now I got liquid Gabapentin for her once a day. She isn't showing any signs of bleeding ulcers right now. Other than the weird feeding thing she pees and poops pretty good all on her own.
I wish I could do surgery for her but the money just isn't there. Even with the knuckling do you think she will have a good chance at walking normally again?
I will call the Vet and get her the sucralfate and give her the pecid twice a day. Thank you so much . If I need to change anything with the new current meds please let me know.
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bart
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Post by bart on Mar 16, 2013 23:51:40 GMT -7
Also I had one other question. She does lick her front paws a lot. I forgot what this means?
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 17, 2013 9:56:30 GMT -7
OK, I just now put it together Tracy's Lola from Yahoo List. duh! LOL Well, this is becoming a complicated case with all the switching from steroid to NSAID back to steroid. Did you discuss and agree on a washout time? What is the plan if during the washout there is worsening of neuro functions...would that mean an emergency to cut the washout time short and take a risk to move to the Pred? Let us know the plan you and your vet have in mind. Glad to hear you are proactive by getting sucralfate added to the Pepcid AC. Can you bring us up to date on her meds by listing the exact names, the dose in mg and how often you are to give them. Also what date would you be starting the Pred? Did you get the Gabapentin from your local pharmacy or a veterinary compounding pharmacy? The only caveat I have about liquid gabapentin is if it has been prepared for humans it likely will contain the toxic to-pets-sweetner: xylitol. On the bottle it will not indicate which sweetner. You would have to specifically ask the pharmacist what is the name of the sweetner they used. If liquid gabapentin is compounded by a vet pharmacy it should contain a safe-for-dogs sweetner. Everyone has experienced numbness or pins and needles tingling in your legs when sitting in a bad position for too long a time. Your dog can be feeling abnormal nerve sensations that are mild pins and needles to quite painful burning, on-fire feeling that makes them bite to stop the pain. These are abnormal signals explaining why a paralyzed dog can feel this neuropathic pain. You need to stay on top of observing for licking to progress to chewing on body parts as this can lead to death. Immediately put a e-collar on or a lengthwise folded towel and secured closed with duct tape to prevent reaching the lower body. Gabapentin can help to control these very painful sensations. We daily see dogs repairing nerves from a more deteriorated level of loss of tail wags to waking again. Nerves can repair. Of course we want to do everything possible to avoid getting to no tail wags or loss of deep pain sensation by 100% STRICT crate rest 24/7 only out at potty times for 8 weeks. Do you soak her kibble to make it easier for her to eat. Did the vet say the disc problem is in the neck? If you believe it maybe, please do these extra things to help: www.dodgerslist.com/literature/cervical.htmYou are doing a good job of advocating for Lola's needs!! |
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bart
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Post by bart on Mar 19, 2013 13:28:11 GMT -7
I decided to switch her back to a steroid only because she was in some pain still on the Rimaldyl and she also had finished on last friday. Which is 5 days now and was wondering if it is ok to start her on the Steroid now because I barely touched her this morning and she started yelping. I wish I could say that my Vet was knowledgeable with this kind of situation but they are not in the least. Luckily for this page I can get her the help she needs.
Her current meds weighs 12 lbs
Tramadol 50mg every 8 hrs
Sucralfate 1gram every 12 hrs (given 2 hours before meals or meds)
Gabapentin 150mg/ml Giving only 0.4ml once a day for 30 days
Prednisone 5mg 1/2 tab every 12 hours for 7 days then 1/2 tab every 24 hrs for 14 days (haven't started due to wash out period)
Pepcid AC 5mg twice a day
The gabapentin was mixed at the vet and they said it was chicken flavor. I don't think it has xylitol in it. I would hope a vet knows better.
No chewing on the feet just licking here and there. She is back to drinking water and eating well. I give her soft food only at this time cause I didn't want her to become constipated. The soft food is the one they sell in the refrigerated section that is all natural and comes in a tube.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 19, 2013 13:39:27 GMT -7
Lola has been w/o anything to reduce inflammation during the washout. Sorry to hear she is in such pain. Since your vet has prescribed the pred I would perhaps chance it and give it now. I would also be extremely watchful for any signs of stomach issues. In fact if it were my dog I would go ahead and request and Rx of sucralfate and double stomach protection. as always do you own homework on each of Lola's meds: www.marvistavet.com/html/pharmacy_center.htmlKeep her on the same diet so there is no confusion of what appears to be stomach problems between temporary diet changes and serious pred side effects (doesn't want to eat, vomit, diareah, blood in the stool) How much does Lola weigh? |
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bart
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Post by bart on Jun 20, 2013 8:38:14 GMT -7
Hi Paula,
I wanted to thank you and give you an update on Lola. She is out of her crate for some time now and doing great! She is back to running around just like she used to. I take her on small walks right now. She doesn't seem to want to go far from home anyway. She loves her crate. But she definitely needs to get some exercise. I had a couple of questions for you.
Medication wise what do I keep her on? Right now she is still on all her meds. (tramadol, carafate, neurontin, and prednisone) And how if at all can I wean her off the meds? Also how much exercise should she be doing everyday? Thank you so much for putting this website together and helping all of us here. It is so invaluable!!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 20, 2013 9:01:48 GMT -7
Tracy, this is not a good idea at all to be off of crate rest and still on the powerhouse meds. There has been no test of a taper off of Pred to verify all the swelling is gone? If there is pain on the taper that lets the vet know at once pred needs to be used a bit longer. If there is no swelling then the taper finishes and no meds at all are needed.
To stay on the powerhouse meds and there is no pain is just to use them for no benefit but the potential to incur ALL the adverse side effects these big gun meds can have.
Please explain more why she is s till on on the meds, why your vet has not given you a taper schedule before going off crate rest to verify the status of swelling in the spinal cord.
Please get with your vet today and get a schedule for tapering off of pred and stopping the pain meds.
Did Lola complete all 8 weeks of crate rest before you stopped the 100% STRICT crate rest 24/7?
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bart
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Post by bart on Jun 23, 2013 0:11:22 GMT -7
Thank you so much Paula. I had no idea and apparently neither does the vet. I will call the vet right away and discuss a taper off the meds. Lola did the full 8 weeks of 100% crate rest. She started walking soon after that. Then she was in a little pain so I kept her on the meds and she seems fine now so I wanted to start getting her off the meds. I already started taking tapering off o the tramadol. Just didn't know how to taper the pred. and neurontin(gabapentin). Thank you for the quick response!
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