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Post by Samantha & Molly on Nov 1, 2019 14:17:21 GMT -7
Molly disc episode - 10/30/19 Molly had surgery in 2014. She’s partially paralyzed & does not have bladder/bowel control. She is able to “spine walk” and she has Eddies Wheels carts for longer walks. She was trembling, head held low & ears back when I got home from work Wednesday. I assumed it was from the drastic weather change (temp dropped 20 degrees in one afternoon). At dinner time she yelped a couple times while sitting on couch... this is out of character for her. I knew it was odd so I took her to UT emergency Vet. She has done rehab at their facility a couple times over the past few years. The doctor that saw her Wednesday night said given Molly’s history she may be having another disc issue, potentially in the neck to shoulder region ( C1-T2). Doctor suggested 4 weeks crate rest & prescribed Methocarbamol, Meloxicam & Gabapentin. [Moderator's Note. Please do not edit 11 lbs Meloxcam as of 10/30: 0.3 mL 1x/day for ? days, then a test stop to reveal any: _pain / _neuro methocarbamol: 125 mgs 3x/day gabapentin ?mgs in one mL?: ? mgs (1mL) 3x/day no GI tract protector, Pepcid AC, on board w/Meloxicam! ]
Should I start giving her Pepcid? If so.. what dosage?
Having spent $6K just 5 years I could not see spending $3K for an MRI (especially since I know now how to deal with partial paralyzed dog) so I opted for conservative crate rest. I’m here for opinions or feedback from other owners that have had a similar issue. A dog that has had surgery and has been extremely manageable (once I learned how to express bladder & qtip method for bowel movements. Today is Friday afternoon & Molly doesn’t appear to be in pain (wants to get up and walk, barking at any noise she hears, head help up, skeet, let’s me pet her), normal appetite/drinking. Is it possible the sudden drop in temp affected her (like a person with arthritis when it rains/gets cold?) When she stands in her crate her back legs are as strong as they have been, tail is still wagging, etc. I appreciate any feedback!! Thanks - Samantha
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Post by Romy & Frankie on Nov 1, 2019 14:55:42 GMT -7
Welcome to Dodgerslist, Samantha. We are 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. It sounds like you have done a very good job with Molly. A dog treated surgically for one episode can be treated conservatively for another episode. A number of our members have done this. The symptoms sound like a disc problem in the neck. The meds have made her feel better.
Crate rest for a dog being treated conservatively is different that post surgery crate rest. It is much stricter. With surgery, the disc pressing on the nerves of the spine is removed. With conservative treatment the hope is that over time the disc material where it should not be will shrink back enough so that pain resolves and nerves can start to self repair. Too much movement and the damaged disc can tear more, even rupture, causing more pain and possibly more nerve damage, even paralysis. The hallmark component of conservative treatment is the 8 weeks of 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. www.dodgerslist.com/literature/CrateRRP.htmIVDD dog on anti-inflammatories, like Meloxicam , are at risk for stomach damage caused by excess stomach acid. To reduce that risk a stomach protector like Pepcid AC is important. Ask the vet 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).
Doxie weight dogs: 5mg Pepcid AC (famotidine) every 12 hours. The link below has information on Pepcid AC.
STRICT means:
◼︎no laps
◼︎no couches
◼︎no baths
◼︎no sleeping with you
◼︎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. How much does Molly weigh? How many days has the Meloxicam been prescribed for ? Please list the doses in mgs and times per day given for all Molly's meds. I am glad that Molly is not showing any signs of pain. The signs of pain we look for are;☐shivering, trembling ☐yelping when picked up or moved ☐reluctant to move much in crate such as shift positions or slow to move ☐tight tense tummy ☐can’t find a comfortable position ☐Arched back ☐ Holding front or back leg flamingo style not wanting to bear weight ☐head held high or nose to the ground ☐Not their normal perky selves? Full pain relief is expected in 1 hour and stays that way between doses. If at any time pain is not in control your vet needs to know right away so the meds can be adjusted. It will be easy for you to get back up to speed on IVDD. 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: --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:
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Post by Samantha & Molly on Nov 1, 2019 15:28:12 GMT -7
Molly weighs 11 lbs
1.5 mL Meloxicam —-0.3 mL every 24 hours 25 mL Gabapentin 1 mL every 8 hours 8 Methocarbamol 500 mg (1/4 tablet) ever 8 hours
Should I start giving her Pepcid? If so.. what dosage?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Nov 1, 2019 15:47:40 GMT -7
Samantha, so sorry to hear your Molly is suffering with a neck disc. Glad to hear with the meds on board the pain is fully in control. --- Here are the extra things you can do to help at home for a neck disc: www.dodgerslist.com/literature/cervical.htm-- What signs of pain did the vet observe where he thought the disc was in the neck?
SIGNS OF PAIN: ◻︎ shivering-trembling ◻︎ yelping when picked up or moved ◻︎ slow to move ◻︎ tight tense tummy ◻︎ arched back, ears pinned back ◻︎ slow or reluctant to move much in crate such as shift positions ◻︎ not their normal perky selves + which NECK disc pain signs: ◻︎ head held high or nose to the ground. ◻︎ restless, can't find a comfortable position
◻︎ 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
MEDS could you give us additional clarity: -- Meloxicam: For how many days is she to take it? -- how many mgs of gabapetin are in one mL of liquid. this infor should be on the bottle. You then given 1 mL as a dose every 8 hrs? -- Pepcid AC 11lbs X 0.44 mgs Pepcid AC = 4.84 mgs Pepcid AC. You can round it up to a full 5mgs every 12 hrs. The usual dose during a disc episode is Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. Give the anti-inflammatory with a meal as added protection. www.1800petmeds.com/Famotidine-prod11171.html
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Post by Samantha & Molly on Nov 1, 2019 15:59:37 GMT -7
Meloxicam: 5 days 50 mgs of gabapetin... so 5 days for the one too We are on day 2. You then given 1 mL as a dose every 8 hrs? Yes
If only 3 days left is it necessary for Pepcid?
[Moderator's Note. Please do not edit 11 lbs Meloxcam as of 10/30: 0.3 mL 1x/day for 5 days, then 11/4 a test stop to reveal any: _pain / _neuro methocarbamol: 125 mgs 3x/day gabapentin 50 mgs (1mL) 3x/day no GI tract protector, Pepcid AC, on board w/Meloxicam! ]
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Nov 1, 2019 16:21:24 GMT -7
Yes, Pepcid AC needs to be added ASAP no matter how many days are left of the Meloxicam. GI tract distress can arise at any time during the taking of a NSAID such as Meloxicam and can arise very quickly with little warning, Samantha. Plus, even though Molly is scheduled to stop the Meloxicam in a few days, she may need it for a longer time. Here's why. It can take 7-30 days for the swelling pressing on the nerves of the spine to resolve. Until the swelling goes down and is no longer pressing on the nerves of the spine, all meds are needed. Your vet has given a rather short course of Meloxicam, only 5 days, so the swelling may not be gone yet. The only way you'll know whether there is still swelling is whether signs of pain return once the Meloxicam and pain meds are stopped. If there is no pain, then no further need for any meds. If you do see any sign of pain return, you'll need to immediately alert your vet of the signs of pain you see so Molly can be returned to all meds for a bit longer, maybe another week or so.You mentioned that the vet gave you five days worth of Gabapentin so that will be gone the same day as the Meloxicam stops. What about the Methocarbamol? Will that be stopped on the same day as the Meloxicam, too? If not, please speak to the vet about stopping or tapering all of the pain meds when the Meloxicam is stopped so a true test for pain can be made. You don't want pain meds to mask the pain that you'll need to see in order to know whether swelling is still there. More info on the inflammation phase of IVDD here: www.dodgerslist.com/literature/healingsweling.htmHealing prayers for Molly.
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Post by Samantha & Molly on Nov 1, 2019 16:27:07 GMT -7
I’m a little confused... it’s NOT good to stop all meds at once? Or am I supposed to want one to be taken longer?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Nov 1, 2019 16:37:01 GMT -7
Sorry for any confusion, Samantha. Yes, all meds (Meloxicam, Gabapentin & Methocarbamol) can be stopped at once if that is what your vet has prescribed. Once the meds stop, you'll need to be on the lookout for any sign of pain returning and if you do see any pain return, you'll need to immediately let your vet know. Pain = swelling = more time on all meds. So if you see pain, there is still swelling and you need to let your vet know so the meds can continue for awhile longer. If no pain returns, then the swelling is gone and no need to start meds again. Is that what the vet wants you to do? Stop all meds five days after starting them? The best thing you can do for Molly is to learn all that you can about this disease so you have a good understanding of how it's treated and what to expect. The best place to start your education is on this page: www.dodgerslist.com/healingindex.htm
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Post by Samantha & Molly on Sept 22, 2020 10:42:46 GMT -7
Molly had surgery approx 6 years ago. She is 10 years old and her vet recently recommended taking Rimadyl daily for anti-inflammation. Does anyone else give Rimadyl long term? Some of the Google searches scare me...
Just wanted to see what other IVDD owners thought/experienced.
Thanks- Samantha
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Sept 22, 2020 11:02:12 GMT -7
Samantha, can you tell us the reasons, the symptoms that has your vet recommending the use of daily Rimadyl?
Has Samantha had a disc episode since her OCT 2019 one?
What do you observe that had you contact your vet for help with Molly?
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Post by Samantha & Molly on Sept 22, 2020 11:37:19 GMT -7
Paula, Thanks for the quick reply.. At her most recent exam our Vet thought she seemed a little more tense in her back/neck area. Due to her age and IVDD he suggested a daily dosage. Molly has not a disc episode since Oct 2019. She's just getting older and she does have spasms in her back periodically. I have posted about them here (mainly weather related as best I can tell.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Sept 22, 2020 11:57:07 GMT -7
Thanks for adding in more detail. It may be trial and error to find the right product to help. Maybe there is not a need for daily meds. Maybe when you observe signs you administer medications. May it ends up there is a daily med need. 1. If there is thought arthritis, then a NSAID that is specifically targeted to the pain from arthritis vs. Rimadyl a broad spectrum (more powerful) NSAID may be something to discuss with the vet. Galliprant (NSAID for arthritis). Homework reading: Galliprant vet promo flyer/FDA insert: northamerica.covetrus.com/Content/pdfs/P058693.pdf2. ADEQUAN injections at home or at clinic "Adequan is an injectable cartilage component called polysulfated glycosaminoglycan (mostly chondroitin sulfate). Adequan is derived from the windpipe cartilage of cattle. Adequan has numerous beneficial effects for the arthritis including the inhibition of harmful enzymes involving joint cartilage destruction, stimulation of cartilage repair, and increasing joint lubrication. www.adequancanine.us3. non medicine option Assisi Loop (Pulsed electromagnetic fields) $279 with Rx from vet or other similar product on the market www.assisianimalhealth.com/product/loop/ === Why there could be arthritis in the back from: www.spineuniverse.com/anatomy/facet-joints-spines-anatomyFacit URL jpg The intervertebral discs are also a type of joint in the spine, and are bound together by flexible fibers in several circling bands, like a tough fire hose, that make up the outer portion of the disc. Disc joints can bend and rotate a bit but do not slide as do most body joints. The joint is then said to have arthritic (literally, joint inflammation-degeneration) changes, or osteoarthritis, that can produce considerable back pain on motion. This condition may also be referred to as "facet joint disease" or "facet joint syndrome." A protective reflex arrangement arises when the facets are inflamed which causes the nearby muscles that parallel the spine to go into spasm. We therefore see inflamed facet joints causing crooking and out-of posture of the back, along with powerful muscle spasm. Manually 'correcting' this spinal curvature actually depends on relaxing the spastic muscles and not a rearrangement of bony structures. www.spine-health.com/conditions/arthritis/treatment-options-facet-joint-painHope this helps out. Let us know what you and your vet decide helps Molly best.
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Post by Samantha & Molly on Sept 22, 2020 12:43:55 GMT -7
If we do a daily Rimadyl should we do a Pepcid/acid reducer daily as well? Our vet did mention Galliprant but he said Rimadyl would be a better fit. I am not sure if it is due to the tablets being chewable or that Gallipant is a newer drug & less history there or what the reasoning was.
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Post by Romy & Frankie on Sept 22, 2020 13:13:18 GMT -7
I think with a daily Rimadyl an acid reducer like Pepcid AC would be needed. Rimadyl, like all anti-inflammatories causes excess stomach acid. Pepcid AC is effective for only 12 hours and would need to be given twice a day.
Galliprant is a newer medication and it has been tested for arthritis not IVDD. A broad spectrum antibiotic like Rimadyl has been tested on other types of inflammation. Your vet must have thought it a better choice because of that.
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