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Post by Kay & Riley on Mar 30, 2020 6:42:11 GMT -7
[Original subject line:Next steps ] Riley is a 5 yr old 16lb. miniature dachshund. Late last Sunday night [3/22] she showed signs of pain. Thinking it was a muscle I put her in her crate and gave her a Previcox tab that was left from a senior dog. Probable not the best idea. She was diagnosed with IVDD a week ago today [3/23]. She was not better in the morning so I rushed her to our Vet. She had movement and feeling in her legs. She was diagnosed with a L3 injury. I was sent home with Gapapentin 100mg and Metacam 10ml every 24 hrs. It was quickly apparent that her pain wasn't being controlled. We went back to the Vet on Wednesday [3/25]. She seemed to show some improvement ( wobble walk. Weakness mostly on her left side). He increased the ▲ Gapapentin to every 8 hrs and added Tramadol 50mg every 8 hrs per my request and continued Metacam 1 daily. [Moderator's Note. Please do not edit
16lbs
3/22 Previcox (firocoxib) owner's dosing
3/23 Metacam (meloxicam) with no 7-5 day washout from Previcox!
as of 3/23: 10mL dose 1x/day for 13 days, then SUN 4/5 test for _pain/ _neruo
gabapentin 100mgs ▲3x/day
tramadol 50mgs 3x/day
needs GI tract protector, Pepcid AC, on board w/Metacam! ]Riley has been on stricked crate rest for a week and is improving everyday. I realize she has 7 more weeks to go. She is pain free, alert and wags her tail. I use a sling to take her outside. I have a bunch of questions. Should I cut back on her food being she is inactive? I've been giving carrots as treats and adding pumpkin/warm water to her dry food. This past week she only poops once a day and [March 29th] holds her urine till she is in pain. Today was the first morning she peed and then pooped like the good old days. It's been cold and rainy so that might have added to her lack of enthusiasm. She is a typical doxy. Also what is my next step? Do I wait two weeks then stop meds and check her pain? Lastly I do quilting and my sewing room is upstairs. I carry her up and I have a small crate where she can see outside and enjoy the sun. We usually stay there 3 to 4 hours. Is it ok to move her from her pen in the great room? The bright side of social distancing is I get to stay home and care for her 24/7. I think we are doing well and hope she will be outside running and enjoying our walks again soon. Her bonded cousin Casey is always by Riley's side...well as close as outside a crate as she can get. She is the unhappy nurse. |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 30, 2020 8:51:48 GMT -7
Kate, very good question you have asked about what the the next steps for Riley's care. The reason for reading and understanding the anti-inflammatory therapy your vet prescribed is to be able to quickly recognize a problem and take action. Such as your giving Previcox and then your vet Rx's a different NSAID (Metacam) without a 5-7 days washout. Plus the switch to Metacam and not even a stomach protector was prescribed! Let us know that today you will Pepcid AC on board. 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. Proactive vets know switching between Previcox (even if just one dose) to Meloxicam that the GI tract needs protection with not only Pepcid AC but PLUS sucralfate. 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).
HEALTH ISSUES: “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 SELF EDUCATION During a short vet visit your vet does not likely have time to educate you on all the details of of non-steroid therapy such as Metacam. Being fully up to speed means the ability to act quickly to prevent needless pain. To act quickly to prevent possible permanant neuro damage because hours really do matter in taking quick action. Valuable information: 1) "How anti-inflammtories are used with a disc episode" www.dodgerslist.com/literature/healingsweling.htm2) "Each of the four phases with what it takes to heal, how long" www.dodgerslist.com/literature/healingpage.htm3) Handy card to carry with you. Keeps the many meds your dog could be Rx'd straight. Helpful as you discuss things. D/l to print a copy at this link: www.dodgerslist.com/literature/MedCard.pdf Crate upstairs in your sweing room is a good idea! Now is not the time to cut back food or go on a diet. The body has many jobs to do and needs proper nutrition. Carrots, small bits of apple, frozen low salt/no fat meat broth ice cubes to lick on are good treats. Let us know you are on the same page about crate rest. The centerpiece of "DISC disease" treatment is the healing of the disc via limited movement of the back via a recovery suite. Crate rest is not your dog in a cage. It's a "recovery suite" with room service!
Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm
PLUS further guidance on conservative treatment on our "All Things IVDD page: www.dodgerslist.com/literature/healingpage.htm www.dodgerslist.com/healingindex.htm
STRICT means:
- no laps - no couches
- no baths - no sleeping with you
- no chiro therapy - no dragging or meandering at potty times.
Carry your dog to and from the recovery suite to the potty place and then allow a very, very few limited footsteps.
A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. No other dog is out at the same time Riley is pottying. 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!
**  I'll best be able to comment on other things after learning the date that goes with each event you mentioned. Additional questions ~ Pepcid AC on board yet? ~ Can you explain more... what do you see that has you using the word pain?: " This past week she only poops once a day and holds her urine till she is in pain" ~ Metacam started on 3/30, correct? what date are you to stop Metacam? This tells us the #-day course. Many times the first course will be a 7-day or maybe a 14-day course. When the course stops it is a test to find out if all painful swelling is gone. or Whether another course is needed to fully resolve the pain of inflammation around the spinal cord. |
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Post by Kay & Riley on Mar 30, 2020 13:48:43 GMT -7
She started showing signs on Sunday March 22. We saw our Vet on Monday March 23rd. Then again on Wednesday the 25th.
That is when Tramadol was added. I have enough medication to last two weeks.
March 29th she held her urine all day. She was trembling and and cried out when the scarf was around her middle. She finally peed at 10:30 pm and all was fine after. She was lije a new dog and I was so relieved. Her abdomin was soft and no more trembling or crying. She even wagged her tail.
Today March 30th was a great day. She was able to pee on command and very happy. I'm making sure to keep movement to a minimum. She wants to be with her friend so badly and I think she would run if she saw a squirrel. I keep her harness on and hooked to her leash. I promise to get Pepcid AC tomorrow. We live rural and the virus is keep us isolated for now.
I'm so happy it's ok to bring her upstairs. It's a routine both dogs love and it gives her a change of scenery and sunshine.
I'm seeing improvement every day. Don't worry I will continue the crate healing the full 8 weeks. I have my calendar marked.
Tramadol 50mg every 8 hours
Gapapentin 100 mg every 8 hours
Metacam 10 ml once a day
Soon to add Pepcid AC
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 30, 2020 18:21:28 GMT -7
Kay, keep us the good work of ensuring she will not be escaping, darting orr or any other excessive movement. Want to protect the work her body has been doing on repairing and forming the disc's scar tissue. Glad to hear Riley, enjoys being upstairs--- that is good to keep her spirits up.
QUESTION
What date does the Meloxica stop? It began on March 23. We are trying to learn how many days is this course of Metacam.
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Post by Kay & Riley on Mar 30, 2020 19:00:01 GMT -7
I'm not really sure how long the meloxidyl will last. I was given a bottle of suspension of 1.5mg/ml containing 10 ml. The syringe for dosage is listed in lbs for the dog and not cc s. I was thinking it must be enough for the two weeks or more. Seeing the improvement in Riley is such a relief and confirmation that we made the right decision to go the conservative route. It's so hard not to second guess yourself. The cost of surgery was never a consideration. I just wanted to do what was best for her. Thank you for all the wonderful information. This is her partner in crime Casey. They are first cousins born on the same day. Never far apart even when one is on restriction.  |
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Post by Julie & Perry on Mar 30, 2020 19:54:33 GMT -7
Conservative crate rest has worked well for both of my dogs.
So glad Riley is responding well!!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 30, 2020 20:30:40 GMT -7
Kay, when you can, call the vet's office to find out how many days Riley is to be on Metacam (meloxicam). This is important information for you to understand as it is for us as well. No one wants a dog on this med any longer past the benefit. A vet must guess how many days.. You want to know how many days the guess is, so you can voice concern if it would be necessary. You will have a better understanding of what I mean after you have read this info. If you have question let's then discuss. Here is the link: www.dodgerslist.com/literature/healingsweling.htm |
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Post by Kay & Riley on Mar 31, 2020 9:05:14 GMT -7
My Vet suggested to stay on meds for 4 to 5 more days. Then discontinue and watch for signs of pain. I'm to make sure I have meds in reserve so I can restart if needed.
Riley is doing really well. I keep using the sling, but she doesn't need much if any support. Her gait is a bit stiff and not yet normal, but she no longer knuckles under with her left paw. She is one happy pup. I do have to place a cover on top of her pen when I leave the house because when I return she wants to stand and jump to greet me. I'm really trying to keep her under control. Luckily she is the calmer of my two. I see how hard this is going to be in the coming weeks. I'm not complaining... I'd rather it be so than have this happen again. So hard to see them in pain. I started the ✙ Pepcid today.
[Moderator's Note. Please do not edit
16lbs
3/22 Previcox (firocoxib) owner's dosing
3/23 Metacam (meloxicam) with no 7-5 day washout from Previcox!
as of 3/23: 10mL dose 1x/day for 13 days, then SUN 4/5 test for _pain/ _neruo
gabapentin 100mgs 3x/day
tramadol 50mgs 3x/day
✙Pepcid AC 5mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 31, 2020 9:44:47 GMT -7
Kay, you are really doing a fine job of supporting Riley's need of limited movement. Already you are seeing signs that her nerves are self repairing.
Really hope the 13-day course of Metacam will do the trick of getting all swelling resolved. Fingers crossed for you guys. Let us know which your vet is wanting at the Metacam stop test Sunday, Apr 5 in order for you to have the ability for a quick and accurate assessment on pain if it should resurface.
~ Does your vet want a full stop of the pain masking meds on 4/5 (gabapentin & tramadol)? OR...
~ Does your vet want to begin 4/5 to taper these two meds
It is your vet's preference, so let us know which he wants you to do.
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Post by Kay & Riley on Mar 31, 2020 19:14:05 GMT -7
We are going to try a total stop of all meds [Sunday, Apr 5] and see if pain resurfaces. I'm hoping for the best but will be ready to resume meds at the first sign of discomfort. She is back on her daily schedule. She goes out in the morning after eating, and before bed. Always with great results. She is pretty happy to be carried. The minute she is finished outside she stares up at me commanding her ride back inside.
I do feel bad about giving her the 1/2 tablet of Previcox the night before taking her to my Vet. Due to the Virus and social distancing I had to wait in my car during the initial exam. I didnt have a chance to inform him of the medication, nor did I know it had consequences. He is a wonderful caring doctor, who always listens and I want you to know it was my doing not his. He has been in contact to check on Riley's progress. If all goes well we will see him again in May. About the time Riley's Crate rest is finished she is due for her rabies vaccine. Thank you for your support and information.
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Post by Julie & Perry on Mar 31, 2020 21:05:50 GMT -7
We all make mistakes when learning about IVDD, myself included!
When you know better, you do better.
Moving forward, read, read, read about IVDD. Educating yourself is your super power to help Riley.
You are doing a great job advocating and caring for her.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Apr 1, 2020 4:48:54 GMT -7
Julie has given you very wise words - when you know better, you do better. Knowledge gives us the power to fight this disease and you're learning more every day. Luckily no harm was done and I'm so glad to hear that you have a vet that you trust.
Blessings to you and Riley.
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Post by Kay & Riley on Apr 11, 2020 14:56:36 GMT -7
Update
I took Riley off all her medications on April 4th. Later in the day she seemed uncomfortable. Shallow fast breathing when I picked her up and not moving around in her pen. I spoke with my Vet and we decided to resume the Gapapentin every twelve hours and the Metacam once a day along with the Pepcid.
I continued this until April 9th and again went off all meds. Riley is doing wonderful.
No signs of pain or discomfort and no longer on any meds. She is walking normal and not showing any weakness in her hind legs. She no longer needs any support other than a leash and harness to keep her under control. I continue to carry her out and in for bathroom breaks.
[Moderator's Note. Please do not edit
16lbs
3/22 Previcox (firocoxib) owner's dosing
3/23 Metacam (meloxicam) with no 7-5 day washout from Previcox!
as of 3/23: 10mL dose 1x/day for 14 days, then SAT 4/4 test for ✓4/4pain/ _neruo
as of 4/4: 10mL dose 1x/day for 5 days, then 4/9 stop test for _pain/ _neruo
gabapentin 100mgs 2x/day STOPPED
Pepcid AC 5mgs 2x/day] STOPPED
She is still on total crate restriction, although not as happy about that as she use to be. We have installed ramps inside and outside of the house. I'm working with our other Doxie, Casey, to use the ramps and it's going well. They are quick to pick up on new things. Very clever little girls. Casey sees it as a new game that comes with praise and rewards. Hoping Riley will follow her lead when the crate restriction is over. My calendar is marked and hoping we all survive 5 more weeks of crate restriction.
Thanks again for all your support and information.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Apr 12, 2020 4:28:29 GMT -7
Such good news that Riley has been able to get off of all meds and is walking normally once again, Kay. I'm so glad to hear it. Great to hear about the ramps, too.
You're doing a wonderful job caring for Riley. Please continue to keep us updated, especially towards the end of the crate rest period as we'll have more tips on how to very gradually reintroduce Riley to more movement. Please let us know too if you find that Riley is moving around too much in her crate as we can provide tips on how to calm her now that she's feeling better.
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