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Post by Martina & Remi on Feb 5, 2020 11:43:37 GMT -7
Hello. I went to the vet Monday the 3rd after finding my dachshund unable to move. Went for a same day appointment and was told there was a spinal issue l2 and l5 with no mention of ivdd or strict crating for 8 weeks.
He is 20.9lbs born 04/2015. He received a dexdomitor injection, antisedan injection, butorphanol injection, prednisone 5mg, gabapentin 100mg.
[Moderator's Note. Please do not edit
20.9 lbs
Prednisone as of 2/3: 5mgs 2x/day for 5 days, then 2/8 test taper for _pain/ _neuro
dexdomitor injection (sedation)
antisedan injection (reverses the effects of dexdomitor)
gabapentin 100mgs 1x/day
needs GI tract protector, Pepcid AC, on board w/prednisone!]
She suggested crating him for 24 hours and Is now able to walk (now I know he should remain crated for several weeks). I however woke up this morning to diarrhea on the floor which looks to have bloody mucus in it. I am unable to afford surgery at the moment and will be looking at simply keeping him crated. Is the diarrhea a reason to be concerned? I’ve seen Pepcid C recommended and I called but our vet wants to see him (I’ no longer have confidence in her and do not want to spend money on an unnecessary visit).
No shivering, no trembling, no yelping when moved, yes he is slow to move [pain] , yes he has a tight tense tummy, yes he is now able to find a comfortable position with medication. He is fine with holding his weight. He is not eating well. The vet is a general DVM.
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Post by Julie & Perry on Feb 5, 2020 12:25:20 GMT -7
Your dog is showing signs of gastric distress. Call vet and get sulcrafate and get OK for pepcid ac/famotidine. You need double stomach protection immediately!!
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Post by Romy & Frankie on Feb 5, 2020 15:07:03 GMT -7
Welcome to Dodgerslist, Martina. 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 is important to know that disc disease is not a death sentence! Struggling with quality of life questions for your dog? Re-think things:
Julie is correct when she say that Remi is showing signs of gastric distress which can become very serious quickly. All anti-inflammatories cause excess stomach acid which can result in GI tract damage. The chance of damage is reduced with a stomach protector like Pepcid AC. But the bloody diarrhea is a sign that damage has already begun. If you are certain Remi does not have any kidney, liver or heart health issues, start Pepcid AC right away and let your vet know about this. You can get Pepcid AC (famotidine) at almost any drugstore or supermarket in the US. The usual dose of 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.
Sucralfate is another medicine that helps protect the GI tract. Sucralfate not only “bandages” the damaged area but accumulates healing tissue factors in its bandage; it not only protects the stomach but actively assists in the healing process. Sucralfate is a prescription medicine and must be gotten from the vet. Transport for an IVDD dog can be risky because it may result in too much movement of the back. Having just seen the vet two days ago, you should not have to bring Remi in again. Try calling the vet again, explain about the bloody diarrhea and advocate for the Sucralfate. These are the signs of pain we look for; ☐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. The tight tense tummy and reluctance to move indicates that pain is not in control. Your vet needs to know asap to adjust meds.
What we have seen work best in controlling the pain of an IVDD episode is three pain meds on board each attacking pain differently: Methocarbamol for painful muscle contractions. Tramadol Rx'd 3x/day as the general pain reliever Gabapentin for nerve pain also Rx'd 3x/day
Your vet may not have enough IVDD experience. If he will not work with you and you do not have confidence in him, consider seeking out a Vet that knows this disease. This article shows what to look for in a Vet that treats IVDD www.dodgerslist.com/literature/VetchkList.htmPlease list the exact names of meds currently given, their doses in mgs and times per day given. Are you giving the pred 2x a day. For how long was the pred prescibed? When does the taper start?
You are right about the crate rest. 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. www.dodgerslist.com/literature/CrateRRP.htmSTRICT 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.
Can Remi 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.
Dogs 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!
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 There is an excellent video series here: PRINT OUT this link and tape to your fridge:
--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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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 5, 2020 17:43:23 GMT -7
Martina, your dog IS showing signs of pain ( slow to move , yes he has a tight tense tummy) because he is only on one pain med when there are three differerent sources of pain. How often was pain med gabapentin prescribed for?
Adovcate with the if possible tonight or first thing in the am for the other two pain meds (methocarbamol and tramadol)
Did Remi have an xray and thus the reason for dexdomitor and antisedan? It is an emergency tonight to get Pepcid AC on board. Red flag signs fof not eating and blood in the diarrhea. Go to the grocery store tonight and get 10 mgs Pepcid AC (famotidine) started! Proactive 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. HEALTH ISSUES for you to know about: “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 Please keep us posted on the Pepcid AC on board now. How many days of prednisone before the taper begins?
How many times a day do you give prednisone 5mgs? |
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Post by Martina & Remi on Feb 5, 2020 19:50:29 GMT -7
He was given a quantity of
10 100mg of gabapentin for once a day.
prednisone 5mgs he takes every 12 hours for 5 days and than after the 5 days, he’ll start taking once a day for the next 12 days.
And Yes I did go to Walmart and bought some +Pepcid! How long should the Pepcid kick in? My vet said if the diarrhea doesn’t go away by tomorrow, I need to bring him in.
[Moderator's Note. Please do not edit
20.9 lbs
Prednisone as of 2/3: 5mgs 2x/day for 5 days, then 2/8 test taper for _pain/ _neuro
dexdomitor injection (sedation)
antisedan injection (reverses the effects of dexdomitor)
gabapentin 100mgs 1x/day
+Pepcid AC (famotidine) 10mgs every 12 hours. ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 5, 2020 21:52:03 GMT -7
Martina The pain med is very under medicated at only once a day gabapentin. Please contact your vet ASAP in the morning to report what you observe. that Advocate that any of the pain meds be given 3x/day (every 8 hours). That is because all of these pain meds stay in the body a short time. They lesson at the 8 hrs mark and are not effective in controlling pain. So you can see gabapentin at once a day is insuffient. —Methocarbamol works on the pain of muscle spasms. 3x/day — Tramadol is the general pain reliever. 3x/day — Gabapentin works on nerve pain. 3x/day 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.
Let us know and your vet the details of what you observe: ◻︎ shivering-trembling ◻︎ yelping when picked up or moved √ slow to move √ tight tense tummy ◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground. ◻︎ restless, can't find a comfortable position ◻︎ slow or reluctant to move much in crate such as shift positions ◻︎ 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 ◻︎ not their normal perky selves PEPCID AC (one active ingredient called famotidine) 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.
21lbs dog X 0.44mgs famotidine = 9.24 mgs famotidine 10 mgs every 12 hours. Keep your vet in the loop about Pepcid AC tomorrow. Do CONFIRM 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!) . Pepcid AC start blocking acids in 30 mins. Bloody diarrhea indicates already damage is happening. Tomorrow a.m. call on the phone and request the typical 2nd protector call sucralfate. Sucralfate works in a different way by forming a gel coat over the damaged areas of the digestive sytems (stomach and intestines). You will need to read so you know why you are advocating for an Rx to sucralfate AND so you know the timing with food and with Pepcid AC (famtodine). Here is the link: marvistavet.com/sucralfate.pmlWith conservative treatment the SINGLE most important care in staying inside the recovery suite except for potty time and only the most important of vet visits that simply can't be addressed over the phone. Vet's who know IVDD, understand transports are risky to the early healing disc and handle things like med adjustments over the phone. A 5-day course of prednisone is rather short. And in light that you are reporting pains signs today, will not be expected that all the painful swelling would be gone by Feb 8. Feb 8 is the date to begin the test for pain prednisone taper. Feb 8 would also be the day to stop or back off all pain meds. All vets must guess how long the Pred course should be. Most guess with a 7- or 14-day course and then the test taper. You will want to be up to speed on how anti-inflammatories like prednisone work with a disc episode. This puts you in an educated position to discuss, ask question and speak up for Remi. Here is the link to read: www.dodgerslist.com/literature/healingsweling.htmDid Remi have an xray while in the clinic for 12 hours? Just asking xray is not usually needed.
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Post by Martina & Remi on Feb 7, 2020 13:29:03 GMT -7
I ended up switching vets. I decided to take remi in yesterday who had expierence with ivdd because remi was having diarrhea with blood and was still in a lot of pain.
She did keep him on gabapentin 100mg (▲2x a day) but had taken him off of ➖prednisone and replaced it with [only a24! hrs washout] ✙Rimadyl (3/4 tablet 2x a day) along with✙methocarbamol (3/4 tablet 3x a day). She said not to give remi the Pepcid ac unless the diarrhea continues which he didn’t have diarrhea for 20hours and than he had a lot of diarrhea an hour ago.
[Moderator's Note. Please do not edit
20.9 lbs
Prednisone as of 2/3: 5mgs 2x/day for 3 days, then 2/6 stopped by new vet
Rimadyl after 24 hrs washout on 2/7: ?mgs 2x/day for ? days, the test stop _pain/_neuro
gabapentin 100mgs ▲2x/day
✙methocarbamol 375 mgs 3x/day
Pepcid AC (famotidine) 10mgs every 12 hours. 2/6 new vet stopped Pepcid AC!!!!
needs GI tract protector, Pepcid AC, on board + sucralfate for quick washout to Rimadyl! ]
Do you recommend me keeping him on Pepcid ac? I also tried getting the tramadol for him but the vet said that she can not prescribe that for him. He just started the new medication this morning. It’s been about 18 hours since he last ate/ drank which he barely had an appetite all week. He’ll have his moments once’s a day where he wants to eat everything and swallow it whole but my vet said only let him eat 3 tbsp every 2 hours which than he won’t eat for another 8 hours or so. I don’t think he’s getting enough, is there anything I can do so that he can regain his appetite? I know it has a lot to do with being in pain. He can still walk but has started to slow down/ is more wobbly and seems tired all the time with his eyes looking heavy/ watery which I believe all of these can be from the medication? What is the chances of him recovering without needing surgery? When do I have to make that decision? When should I start seeing a difference with the medication? What should I do different? I just want my dog to get better and so that he’s no longer in pain and that he can be his normal self. If I could afford it, I would 100% do the surgery. I don’t want to give up on my dog as I have a lot of hope for him.
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Post by Romy & Frankie on Feb 7, 2020 14:15:29 GMT -7
If the vet took Remi off prednisone and put him on Rimadyl the next day and Remi is not eating and has bloody diarrhea, I am concerned that you have a serious situation on your hands. A dog cannot be safely transitioned from a steroid type medicine like pred to a NSAID like Rimady without a 4-7 day washout where no meds are taken. The reason for this is that with the two medicines in the body at one time there is a double jeopardy of stomach acids which can cause serious stomach damage. This can become very serious, very quickly. I cannot emphasize this enough. Remi's not wanting to eat is highly likely because his stomach is bothering him . Not wanting to eat is another sign of stomach damage.
At this point Remi must be on the Pepcid AC as well as Sucralfate. The Pepcid AC alone will not be enough at this point. Please call the vet immediately and report the diarrhea and advocate for the Sucralfate. Please be insistent about this. Remi is already showing signs of stomach damage. He needs both the Pepcid AC and the Sucralfate at this point.
Please read the below information on the dangers of mixing Carprofen with steroid medications. Carprofen is another name for Rimadyl.:
"... NSAIDS should not be used in conjunction with corticosteroid hormones such as prednisone, dexamethasone etc." The quote above and additional information is found here :
If you cannot reach your vet very soon, please consider a visit to an emergency hospital. The danger of mixing steroids and NSAIDs is well known in the veterinary community and when you explain the situation you should be able to get the Sucralfate.
Please keep us updated on Remi.
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Post by Martina & Remi on Feb 7, 2020 14:27:50 GMT -7
He no longer has blood in his diarrhea. I waited 24 hours to give him rimadyl so that the predisone was out of his system just like the vet recommended. If I continue the Pepcid ac, can I give it to him at the same time as the other 3 medications?
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Post by Romy & Frankie on Feb 7, 2020 14:48:17 GMT -7
Pepcid AC should be given 30 minutes before the rimadyl and thereafter every 12 hours (2x/day). The timing of the other meds with Pepcid AC is unimportant.
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Post by Julie & Perry on Feb 7, 2020 17:06:06 GMT -7
If Remi switched from the steroids to the nsaids without a 5-7 day washout period he needs both the pepcid ac and the sulcrafate.
Please see Romy's post above. This is very important. Your pup doesn't need ulcers on top of everything else.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 7, 2020 17:50:08 GMT -7
-- Rimadyl is the lessor of the two classes of anti-inflammatory drugs. The new vet has a bias against prednisone. The new vet does not know about protecting the stomach with Pepcid AC. --- Prednisone (steroid class) is the more powerful in getting painful swelling down. This is why you may be seeing the increased neuro diminishment of more wobbly. Now there is less working on reducing swollen inflammed tissues pressing on the delicate spinal cord. The vet needs to be updated re: your observations. --- Started to slow down.... what exactly are you observing? Is he now in pain? What specific signs are you seeing? -- There is still diarreah!. So the GI tract is still being stressed with this non-steroid anti-inflammatory Rimadyl. Sucralfate (along with must-have Pepcid AC) has a different job than Pepcid AC. It forms a gel coat over any disrupted and aggrevated area of the stomach's protective mucous lining allowing faster healing. -- Any anti-inflammatory should always have Pepcid AC on board to suppress acids. All anti-inflammatory drugs (steroid or NSAID Rimadyl) cause extra acids. -- Prednisone was working, but just like Rimadyl will take 7-30 days to get the job done of resolving all painful swelling. What was needed was the right compliment of pain meds added to give Remi comfort til pred completed the job: That is Gabapentin 3x/day, tramadol 3x/day, and methocarbamol 3x/day. Questions:-- Was the blood red or black, tarry type of digested blood?-- What do you observe that makes you say he is slowing down?-- Let us know you ARE giving Pepcid AC 30 mins before Rimadyl. That you then give some food along with the Rimadyl as added protection. Thereafter give Pepcid AC every 12 hrs (2x/day) because that is how long Pepcid AC stays in the body at an effective level to suppress acids.
-- Let the vet know about there still being diarhea. Let us know you did your homework on sucralfate and was successful in voicing your concern to get that Rx from the vet. |
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Post by Martina & Remi on Feb 7, 2020 18:37:09 GMT -7
The diarrhea was mucus, dark red [undigested blood]. He only had diarrhea once today.
The reason the vet switched the medicine is because it was an anti flammatory medicine which should help prevent the diarrhea problem. She also mentioned that people that get surgery for there dogs are also prescribed Rimadyl.
He won’t eat anything with his meds since he was in so much pain today so the only way was to put it in his throat and close it.
At 4:30pm today, Remi did not want to stand or keep his head up. His head keeps going side to side and he gets very stiff.
I called the emergency vet and he said wait for the second rounds of medication which would have been at 5pm. He said if you don’t see any changes within a couple of hours go to the emergency vet.
It has now been 2 1/2 hours since the meds were given. He seems more relaxed but is still very stiff and doesn’t want to hold his head when I bring him out to go to the bathroom. Otherwise all he wants to do is sleep which I feel is a good thing?. Unfortunately it wasn’t the 24 hours yet for the Pepcid so I had to give it to him after the medication which was at 7. (But I will start giving it to him BEFORE the other medication!) It is now 7:30 and I’m wondering if I should take him into the emergency vet.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 7, 2020 19:42:22 GMT -7
YES, go to ER now. VERY, VERY strongly adovcate for getting that 2nd stomach protector on board. Name is SUCRALFATE. Did you read about it here: marvistavet.com/sucralfate.pml This way you know why you are advocating to protect his damaged areas of the stomach lining and even further down in the intestines. ALSO the reason for ER is that I'm very concerned what the head things is, why he is stiff, and why he does not want to stand. You need to know if his neuro functions are in decline, that is worsening. HAVE NO PATIENCE at all with pain! Pain should be in control in ONE HR or less when the meds are correctly Rx'd. The pain meds are not yet right at 2.5 hrs later. Please contact your vet ASAP to advise of the pain that you're seeing so meds can be adjusted. Advocate that any of the pain meds be given 3x/day (every 8 hours): —Methocarbamol works on the pain of muscle spasms. √ has been Rx'd for every 8 hrs — Tramadol is the general pain reliever. every 8 hrs — Gabapentin works on nerve pain. every 8 hrs 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.
Martina, I'm very sorry there was a typo about Pepcid AC Pepcid AC is given every 12 hours (NOT 24 hrs!!!) The reason for every 12 hrs is that is how long it lasts in being effective in suppressing acidsBring all the old and the new med bottles to ER so that vet will have accurate information along with what you explain.
At ER ask where the vet thinks the problem disc is. Is it in his neck or located in the back area.
Please update. Fingers crossed that Remi will be getting the help he needs at ER, with hopefully a vet who knows more about IVDD. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 7, 2020 19:46:52 GMT -7
Bring all the old and the new med bottles to ER so that vet will have accurate information along with what you explain.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 7, 2020 19:49:28 GMT -7
At ER ask where the vet thinks the problem disc is. Is it in his neck or located in the back area.
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Post by Martina & Remi on Feb 7, 2020 19:56:42 GMT -7
We’ve done X-ray and it was in the lower back. The medication shouldn’t make him from feeling drowsy and wanting to sleep the whole time is it because that is what he’s wanting to do and he’ll let me touch me touch his mouth which isn’t normal. I was hoping it’s just the medication he’s on but from your guys comments. I’m having a gut feeling it’s not 😔
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 7, 2020 21:17:56 GMT -7
Martina, if he is in pain and more wobbly, can't stand, etc. then a vet who can see/examine him and you who can speak up for Remi is what is needed. From this side of the computer we can only highly recommend seeing the ER vet tonight.
--- an Rx for sucralfate that you are not positive the new vet would give.
--- pain med adjustments that is more aggressive. New vet was not comfortable in her knowledge of IVDD, the pain of a disc episode and stomach protection. And not confident to stay the course with prednisone but instead to made a switch to the lower power NSAID, Rimadyl.
--- you'll be getting also a 2nd opinion on what the new vet prescribed.
Is an ER visit tonight not possible?
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