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Post by Russ & Blanche on Jun 12, 2020 12:39:27 GMT -7
Blanche had surgery for a ruptured disc 3/2018, then surgery for a severely compressed disc 10/2018. She's been doing great since until a couple of days ago [6/10] (Wednesday) when symptoms of discomfort started again. I kept old tramadol and gabapentin on hand from last time around and when I felt confident she was in pain ( yesterdayThursday) I gave her 17.5mg tramadol and 50mg gabapentin and [6/11] s tarted crate rest. Had to be sparing with tramadol since I only had a few pills. This morning (Friday) we went to [6/12] ER vet to get more medication to control pain. Neurologist was booked solid and ER doc didn't press for us to se them since Blanche is able to walk and situation was mostly anecdotal other than her visibly being uncomfortable, but they have her records from previous surgeries and gave me more meds. I have a neurology appt set for 6/29. For right now I'm going to put her on crate rest and started giving her: 25mg tramadol 3x day 50mg gabapentin 3x day 12.5mg rimadyl 2x day [Moderator's note: please do not modify
11.7lbs
Rimadyl as of 6/12 12.5mg 2x day for 4 days, then 6/16 STOP test for _pain/_neuro
tramadol 25mg 3x day
gabapentin 50mg 3x day
Pepcid AC still needed]
I was only given enough for about 4 days but I'll get more early next week since I know how this goes and don't want Blanche to end up in pain. She's finally resting comfortably and was able to pee without discomfort about 20 minutes ago unlike this morning when she couldn't stay still while squatting. Blanche took the rimadyl with food, but are there known issues with stomach discomfort or heart burn using this medication? I forgot to ask this question when talking to doc.
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Post by Romy & Frankie on Jun 12, 2020 13:19:44 GMT -7
Welcome back to Dodgerslist, Russ. I am sorry that Blanche is having another disk episode.
Rimadyl, like all anti-inflammatories causes excess stomach acid which can lead to stomach damage. To minimize the chances of stomach damage a stomach protector like Pepcid AC is used. Ask your vet if Blanche 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)
The usual dose in dogs is .44 mg per pound 30 minutes before the anti-inflammatory and thereafter every 12 hours as long as the dog is taking an anti-inflammatory. If Blanche is still around 11.7 lbs, a 5mg tablet of Pepcid 2x daily is a good dose.
Crate rest for a dog being treated conservatively is much stricter than post-surgery crate rest. This is because surgery removes the offending disc pieces and immediately removes pressure on the spinal cord. Too much movement during this time could put more pressure on the spinal cord and cause more pain and neuro deficits. The 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.htm
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.
Carry Blanche 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 a 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!! You can quickly 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 website: |
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Post by Russ & Blanche on Jun 12, 2020 16:15:07 GMT -7
Thank you! I have some generic ✙pepcid from the last time around, so I'll make sure to give some to Blanche half an hour before her next anti-inflammatory. I'm so grateful for this site and all the guidance you provide. I'll keep you posted on her progress.
[Moderator's note: please do not modify
11.7lbs
Rimadyl as of 6/12 12.5mg 2x day for 4 days, then 6/16 STOP test for _pain/_neuro
tramadol 25mg 3x day
gabapentin 50mg 3x day
✙famotidine ?mgs ?x/day]
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Post by Russ & Blanche on Jun 13, 2020 15:20:09 GMT -7
Today (Saturday) at about 7am I gave Blanche 25mg tramadol, 50mg gabapentin, 5mg famatodine. At 7:30am I gave her 12.5mg rimadyl. She was resting comfortably for most of the morning but didn't want to eat until about 11:15am. Right after eating she started shivering again which I assumed was from moving slightly when I fed her (she continued laying down and I fed her from my hand so she wouldn't have to move, but she shifted). I called the vet because the goal is no pain. Dr called back about 30 minutes later and said don't want to increase the painkiller dosage but will give her methocarbamol, a muscle relaxer, 2-3x daily to help her relax and keep from causing more pain from being tense. At 3pm I gave Blanche another 25mg tramadol, 50mg gabapentin, and 125mg methocarbamol.
[Moderator's note: please do not modify
11.7lbs / 5.31 kilograms
Rimadyl® as of 6/12 12.5mg 2x day for 4 days, then 6/16 STOP test for _pain/_neuro
tramadol 25mg 3x day
gabapentin 50mg 3x day
✙methocarbamol 125mgs 3x/day
famotidine 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 Jun 13, 2020 15:39:23 GMT -7
Russ, good job on getting the 3rd part of the 3-way combo of pain meds. Make sure you are giving methocarbamol promptly every 8 hrs. Your vet is uncomfortable in using pain meds during a disc episode. Bone up on Tramadol and gabapentin and IF, if you are finding pain is not being fully control right up to the next dose of those three pain meds, then call back and strongly advocate for a more aggressive pain med approach. How many mgs of famotidine do you give and are you giving that promptly every 12 hours? CAVEAT: You would need to contact your vet, report your dog’s symptoms, and discuss adjusting the dose. The correct amount to administer can depend on several factors including your dog’s breed and medical history. Do not self prescribe for you dog. TRAMADOL The usual in controlling pain is to Rx at the higher end of the mg range AND promptly every 8 hours for a disc episode. 1) Plumb's is considered the "drug bible" of the veterinary world. Tramadol dosing in dogs varies, ranging from 2 to 5 mg/kg every 8-12 hours. The highest dose for maximum analgesic effect in dogs is 10 mg/kg every 8 hours. “Tramadol”. Plumb DC. In Plumb DC (ed): Plumb’s Veterinary Drug Handbook, 7th ed—Ames: Wiley-Blackwell, 2011, pp 1002-1004. 2) Veterinary pharmacologist Bruce KuKanich, DVM, PhD, DACVCP: " Tramadol is rapidly eliminated from dogs after oral administration. Recent studies are suggestive the bioavailability of tramadol in dogs is lower than originally determined and the dose of tramadol needs to be increased with dosages from 5 - 10 mg/kg PO q 8 hours-12 hours in dogs to maintain similar plasma drug concentrations as those in humans." New developments in opioids: old drugs and some future directions (Proceedings)" DVM360. Nov 01, 2009 By Butch KuKanich, DVM, PhD, DACVCP veterinarycalendar.dvm360.com/new-developments-opioids-old-drugs-and-some-future-directions-proceedings Last accessed 3/18/16 |
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Post by Russ & Blanche on Jun 14, 2020 14:40:19 GMT -7
Thanks for that info! I'm giving 5mg of famotidine 2x/day as advised by the vet.
Today Blanche seems totally fine. With previous disc issues she has continuously be exhibiting some signs of pain or discomfort as time for her next medication dose approached, but this time around it's not quite the same. Today she seems totally back to normal. Do many people see this with dogs who have a disc episode? I wonder if the last two times it was more extreme (one disc ended up ruptured and the second was severely compressed by the time pain was exhibited). I don't want to take her off the meds in case they're just working the way they should, but I'm tempted to wait 12 hours instead of 8 to see if perhaps I reacted based on past experience even though I'm not totally sure it's a disc problem this time around. This morning I gave Blanche 1/2 tramadol, 1 gabapentin, 1/4 methocarbamol, 1/2 famotidine, then 1/2 rimadyl 30 minutes later. That was about 7 1/2 hours ago and she seems to be alert and comfortable now. She's not shivering at all and doesn't have any indication of pain or discomfort. As a reminder, her initial symptom was shivering that started on Wednesday, then more shivering and some panting on Thursday which was when I gave her some old pain medicine left over from her last episode, then Friday morning I took her to the ER when she had pain peeing and pooping after waking up. Today she peed and pooped with no problem, though she had received medication at least an hour before that. Would it make sense to wait 12 hours instead of 8 to see if perhaps this wasn't a disc episode after all? It's so hard to know whether I'm doing the right thing. I wish dogs could talk!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jun 14, 2020 18:11:35 GMT -7
Russ, the time to back of pain meds or to full stop them is at the RIMADYL TEST STOP on June 16. Ask your vet which he prefers on the stop....backing off of methocarbamol, tramadol and gabapentin OR a full stop on June 16? Let us know which. The test stop will give you and the vet the answer if Rimadyl and pain meds are still needed or no meds at all. Some dogs can get the swelling down in 5-7 days while other may need to be on meds for up to 30 days. The disc requires 8 weeks to heal. To have a better handle on how meds are used with a disc episode this page is very good, the better to stay the course when needed, not jump the gun, be able to ask good questions and discuss things with your vet: www.dodgerslist.com/literature/healingsweling.htm
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