Welcome to the Forum. Hi, my name is Paula, what's yours? I'm sorry to hear your Gus is having a disc episode. Being ill makes things more difficult. Please let us know how we can further help with ideas to work around your own challenges as you care for Gus.
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Three things to address soonest
The very soonest possible tonight or first thing in the a.m. It sounds like Gus IS in pain with reluctance to lie down, change position from sitting to sleeping.
Of utmost important is to get an understanding of the
very dangerous position your vet is intending on putting Gus in by following a non-steroid anti-inflammatory after giving an IV of Metacam. His use of meds for a disc episode are not typical, showing he is not in a comfort zone about his knowledge of IVDD. Your choice is to either locate a different vet who knows IVDD or that you are a quick read and study person to be able to voice concern and guide this vet to the safe and typical use of meds.
!. How an anti-inflammatory med is used with a disc episode.-- When there is neuro damaged such as the evidence of Gus knuckling under his back paws, most vets would choose the steroid, Dex, over the non-steroid, Metacam.
UNDER NO circumstances would a knowledgeable vet the next day use Metacam.
1) is it a real danger to to the GI tract to not have a 5-7 days washout before use of Metacam.
2) Metacam is less powerful so why would one go there?
-- Dex (a glucocorticoid) may well be the first to get the ball rolling to get that painful swelling that damages the spinal cord down. Then it would be followed up at home with a different steroid in pill form, most often that is prednisone. The prednisone would be Rx'd for 2x/day with a 7- or maybe a 14-day course. It is the tapering of prednisone that allows you and the vet to determine if there is further need with another course or if all painful swelling is gone and the taper goes to conclusion.
--Neves damaged may take longer to heal than the short 8 weeks of crate rest that allows the disc to heal. Nerve healing can be a slow process of many months. There are no meds that heal a disc and no meds that heal nerves.
--Any time a steroid is given, Pepcid AC (famotidine) is given to reduce the extra stomach acids steroids cause to avoid bleeding ulcers.
Important reading homework on using anti-inflammatory drugs (steroids or non-steroids) with a disc episode:
www.dodgerslist.com/literature/healingsweling.htmReferences about NSAID/steroid use
2. How pain meds are used
Gus IS in needless pain, if he is not willing to move to lie down! That is because he is WAY, WAY under medicated for pain. Pain meds do not last long in the body and are Rx'd for every 8 hrs.
--- Tramadol should be Rx'd at least 50mgs at every 8 hrs. Advocate if this is not so with your vet. Do not self prescribe.
--- methocarbamol for the pain of muscle contraction. every 8 hrs.
--- gabapentin for nerve pain. Every 8 hrs.
3.
STOMACH protectionProactive vets don’t wait til there is lip licking of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers, red or black blood in stool due to the extra stomach acids anti-inflammatory drugs cause.
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).
In summary Gus needs:-- STOP metacam scheduled for 10/2
-- Advocate to stay on the steroid class by getting pills for at home: Prednisone
-- Adovocate that 3 pain meds be on board to provide round the clock full comfort from each kind of pain:
1) tramadol at 50mg 3x/day if that has not been Rx'd
2) gabapentin for nerve pain 3x/day
3) methocarbamol for muscle pain 3xday
--Stomach protection is a must do asap: Pepcid AC (famotidine)
-- If he is leaking in his bed, leaking when lifted he has lost bladder control. You will get more out of a hands-on-top-of-your-hands type of expressing lesson by first reading and viewing the video at this page:
www.dodgerslist.com/literature/Expressing.htm Use baby wipes to clean...no baths. too much movement of the back with great potential to harm his spinal cord permanently.
Please do let us know the right meds are finally on board and Gus is pain free. His stomach is protected. And how we can help you with care ideas for Guss regarding your own current limitations
