Tony's Typhon 3/6 Conservative

www.dodgerslist.com/literature/CrateRRP.htm

All anti-inflammatories cause excess stomach acid which can result in serious damage to the GI tract. We can reduce the risk of this by using a stomach protector like Pepcid AC. At Dodgerslist we follow vets who are proactive against not eating, vomit, diarrhea, bleeding ulcers by giving Pepcid AC. The usual dose for doxie weight dogs is 5mg 30 minutes before the anti-inflammatory and thereafter every 12 hours.
Usually a dog is prescribed 5-7 days of a steroid like prednisolone at the full 5mg 2x a day dose and then a tapering dose is prescribed. The date 6/1/20 would only be the date the meds expire. If there is nothing else on the bottle or on any paperwork you have received, when you speak to your vet ask how long Typhon will be on the full dose before the taper starts.

--use the printout as your roadmap to avoid dangerous detours in your dog’s care
--make notes/highlight to keep yourself on track

Then take Typhon into the emergency vet, Tony, ASAP. This cannot wait until Monday for your regular vet. Typhon cannot remain in pain the rest of tonight and all of tomorrow.

It often takes three kinds of pain meds to control the severe pain of IVDD. Tramadol as a general pain med, Gabapentin for nerve pain and Methocarbamol for the pain of muscle spasms. A vet needs to get his pain completely under control within one hour of taking a new course of meds and pain should remain completely under control from one dose of pain meds to the next. The vets have lots of options to control pain.

Transport can pose a risk of too much movement of the spine. Be sure to secure the crate in the car and pad it well with rolled up towels/blankets so Typhon doesn't move too much when you stop or turn the car. And of course carry him in and out of the ER.

Be sure to speak to them about the addition of Pepcid AC (Famotidine), too.

We'll be anxiously awaiting word of how the ER visit goes.

I've used Care credit and they will give you 6 months to a year to pay back without interest.

Or if you don't qualify maybe friends/ family could help.

Prayers for you and Typhon.

Tony, is Typhon taking pepcid ac or the generic famotidine?

Dogs can produce extra stomach acid when under stress and also when taking steroids.

This can potentially lead to stomach ulcers, diarrhea, and gastric distress.

Can you check with the emergency vet and ask if it's OK for Typhon to take pepcid ac?

Tony, check that bottle of gabapentiin. Confirm how many mgs you give 3x/day. 600mgs dose you wrote about is dangerously high.

Were you able to track down the name of the steroid injection on 3/7 from your invoice or calling the vet receptionist?

Is pain now fully in control dose to right up to the next dose of the two pain relievers (mehtocarbamol and gabapentin)?

TEST PRED TAPER
Saturday, March 14 the tapering of the 7-day course of prednisone begins. This is in practicality a test for pain to see if all swelling is really gone. Taper doses of pred no longer work on swelling. Being able to quickly and accurately assess whether painful inflammation still exists or not is an important part of the test in deciding if another course of pred is needed. It can take in the range of 7-30 days (excluding any taper days)  for prednisolone to rid the body of all inflammation. Which does your vet want on the begin of the 3/14 taper:
--- to full stop the two pain meds that mask pain or....
--- to back off the two pain meds

Please do read the full info on how pred is used during a disc episode. An educated owner can best discuss things with a vet and be an advocate for their dog. LINK to read: www.dodgerslist.com/literature/healingsweling.htm

Since the pred taper will start on a Saturday when he is open only half a day and reopens on Monday what is your plan B with this vet?
     With any taper, it is always good to have worked out in advance a "PLAN B" should pain re-surface at night or on the weekend when your vet is not open. Could be an emergency RX script you could fill at local 24 hr pharmacy or some extra pills at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free!

Pain= another course of prednisone + all pain meds, stomach protector back on board.
No Pain= go to conclusion of pred taper... Finish out the 8 weeks of crate rest for the disc to heal.

Tony, thanks for double checking gabapentin.

ALWAYS, it is a better idea to use a combo of meds. Making it less likely for the need of one med being so high in dose. There are three sources of pain. Thus the usual is to address each source of pain with its own pain reliever.
--- Tramadol as the general analgesic. 3xday. For a 15 lbs dog you would be looking for the vet to Rx 50mgs every 8 hrs. That is the max analgesic dose for 15lbs.
--- Gabapentin addresses nerve pain. 3x/day. Dose can then be greatly reduced down from the very high
600mgs every 8 hrs.
-- methocarbamol addresses the kind of pain from muscle contractions. Also every 8 hrs. 125mgs dose is normal for a 15lbs dog.

Hope to hear back with your phone call into your local vet Monday a.m., as to changes in the gabapentin dose and adding in tramadol for a 3-day pain med cocktail that covers each kind of pain typical to a disc episode.

Tony, it is OK to have a blanket. Preferable is a synthetic fleece that wicks away moisture should there be an accident. With doxies it is a lkley good mental health thing to be able to burrow. As long as he is not getting rambutious and you help him cover himself when possible should be ok.

It is ok to open the crate to pet him. How about taking this opportunity to communicate with him and let him know he is doing a good job whenever he is quiety lying down or sitting on his butt.

To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting. So anytime you see wanted behavior that would be the time to reward him, with a pet.
The opposite for UNwanted behavior is to turn your body sideways, avoid eye contact until he calms and settles down.  Preferable is to start teaching what you do want before there is too much practice in doing the unwanted behavior.

Anytime Typhon is sitting or lying down quietly, give a reward of eye contact* and of a calm loving "good sit/lie" as you open the crate door to pet him.
      *Dr, Brian Hare, Professor of Cognitive Neuroscience at Duke University and author of "The Genius of Dogs" explains the meaning of eye contact for dogs:
     --When your dog stares at you he is “hugging you with his eyes.” Try gazing into his eyes when the two of you are calmly relaxing. Speak softly "good lie/sit", stroke gently while maintaining eye contact. According to Hare these quiet moments stimulate the release of Oxytocin in the canine brain—the same hormone that bonds mother and child.