Donna, is the neuro doctor the same as last time, Dr. Gainsburg, DVM?
It is well known that x-rays do not confirm a disc episode. Was there a suspicion of another disease that the dr. wanted to rule out and thus the reason for the xray? Disc episodes are generally diagnosed by breeds prone to them, if the dog has had a previous disc episode and the way the dog acts during a neuro exam.
What was the
name of the steroid you gave on 9/22?
How many mgs? once or twice a day?What are the details of the
pred the Dr. Rx'd on the 9/23 visit?
How many times a day?
For how many day before a taper starts?What is the
name of the antibiotic she is on? ? mgs ?x/day
Does she still weigh 16.5 lbs?Pepcid AC lasts in the body effectively for 12 hours. That is the reason it is given twice a day. Let us know you are adjusting to twice a day to provide optimum protection from the Prednisone.
Pain is a curious thing.
Our dogs are ultimately descended from wild animals. It does a wild animal no good to advertise the fact that it is sick. Most dogs simply adopt a stoic attitude to pain at the vet. At home where you know your dog best you will know something is off. Studies show that dogs have pain threshholds that are almost identical to humans.
So this is where we come from here on the Forum about pain...we side with Dr. Downing. Robin Downing, DVM, CVA, DAAPM is one of only four veterinarians in the world to hold the Diplomate credential in the American Academy of Pain Management - the largest interdisciplinary pain management organization in human medicine: "It is always better to use a multi-modal approach to pain management."
And we side with the World Small Animal Veterinary Association (WSAVA) guidelines as well: "
We canât always know that our patient does hurt, but we can do our best to ensure that it doesnât hurt" Journal of Small Animal Practice. Š 2014 WSAVA. p4.
www.wsava.org/WSAVA/media/Documents/Guidelines/Recognition-Assessment-and-Treatment-of-Pain-Guidelines.pdf Scroll down for table of contents (last accessed 9/21/2019)
đ´ "There is medicine and there is healing. Healing requires rest and comfort, and all patients should be kept as comfortable as possible. Studies have shown a correlation between less pain and faster recovery from illness, surgery, or injury." Barak Benaryeh, DVM, DABVP. Identifying Pain in Geriatric Patients. Veterinary Team Brief. NOV/Dec 2015. đ´
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"One of the psychological curiosities of therapeutic decision-making is the withholding of analgesic drugs because the clinician is not absolutely certain that the animal is experiencing pain. Yet the same individual will administer antibiotics without documenting the presence of a bacterial infection. Pain and suffering constitute the only situation in which I believe that, if in doubt, one should go ahead and treat." Davis LE. Species differences in drug disposition as factors in alleviation of pain. In: Kitchell RL, Erickson HH, Carstens E, eds. Animal painâperception and alleviation. Bethesda, Md: American Physiological Society, 1983:175.
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Jessica Vogelsang, DVM: It wasnât that long ago when people assumed pets didnât feel pain as acutely as humans did. Some even thought that a little pain was good for a pet because it kept them from overdoing it during recovery from a surgery. It was a misguided approach, and modern veterinary medicine no longer works that way. Now, veterinarians are guided by the principle of âassuming pain.â That is, if a pet is experiencing something we know to be painfulâan injury, a surgery, certain medical conditionsâ
we should give a pet pain medication even if he or she isnât outwardly crying or limping.
Donna you know Daisy best, is she in pain? Is she displaying any of these signs of pain?
SIGNS OF PAIN:
âťď¸ shivering-trembling âťď¸ yelping when picked up or moved
âťď¸ slow to move âťď¸ tight tense tummy
âťď¸ arched back, ears pinned back âťď¸ head held high or nose to the ground.
âťď¸ restless, can't find a comfortable position
âťď¸ slow or reluctant to move much in crate such as shift positions
âťď¸ looks up with just eyes and does not move head and neck easily.
âťď¸ not eating due to painful chewing or in too much overall pain
âťď¸ holds front or back leg flamingo style not wanting to bear weight
âťď¸ not their normal perky selves
Typically with a disc episode, as the specialist quotes provided to you above, it will take 2-3 pain meds to provide full round the clock pain relief. Each pain meds works on a different source of pain. Because these pain meds don't last long in the body, vets Rx them for promply every 8 hrs.
âMethocarbamol works on the pain of muscle spasms.
â Tramadol is the general pain reliever.
â Gabapentin works on nerve pain.
There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock.
We look forward to being at the ready to make good comments by having the details about her meds, your observations about pain, weight, Pepcid AC at 2x/day. Thanks!