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Post by Valrie & Blue on Jun 21, 2020 18:19:46 GMT -7
☆ 1 How much does your dog weigh? 15 pounds
Gabapentin 100 mgs been taken since 6/16/2020 every 8 hours,
prednosone 5mg 6/20/2020 1st 5 days 1 1/2 tablet
Amantadine 100 mg 6/18/2020 one a day
[Moderator's Note. Please do not edit
15lbs
prednisone as of 6/20 7.5mgs 1 x/day for 5 days, then 6/25 test taper for _ pain/ _neuro
gabapentin 100mgs 3x/day
amantadine 100mgs 1x/day
needs GI tract protector, Pepcid AC, on board w/prednisone! ]
☆ 2 Which breed? What is your dog's name? Your name? Dachshunds/Chihuahua mix. My babies name is Blue
What country if not United States?
☆ 3 That is what the nuerogolgist said becasue I was not able to afford the MRI or the surgery. I went to both general practice and specialist surgeon neurologist.
☆ 4 crate rest 24/7 for 8 weeks? This started on 6/17/2020
☆ 5 Is there still currently pain He has all the symptoms mentioned above and pain when taken outside. He has not eaten at all today 6/21/2020. Pain meds do not last the entire time. It seems like he needs more
☆ 6 Barely. move the legs at all he can move his front legs but at times they look undtable. He drags his back legs.
He wags his tail every now in them when we are outside and he trying to poop.
☆ 7 He is not squatting his bottom half drags and he starts to pee. No bowel movement today 6/21 i can hear gas and he just sits there and shivers and then starts panting.
☆ 8 No food today, just 2 dog treats to take his medicine no poop today 6/21/20- when he did poop it was normal, just hard for him to get it out.
When I touch his back legs he tries to bite and he yelp in pain. I tried the sling with ace bandage and he cried in pain.
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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 21, 2020 18:57:26 GMT -7
Welcome, my name is Paula, what is yours? Glad you have joined us. PAIN EMERGENCY!!!Hope you have now called your neuro's clinic to report needless suffering with pain. The pain meds are WAY, WAY undereducated for a 15 pound dog. Impossible to care for a dong in pain. Not all fair to the dog to suffer like this. Go to ER if you have to tonight and get those pain meds properly adjusted. Any vet at your Neuro's clinic can read Blue's file. Thus that vet can prescribe an adjustment to pain meds. Otherwise you need help from ER. Not at all fair for Blue to be subjected to pain , when meds are available and can be adjusted. Let us know how things go tonight. Unfortunately if you need ER help, then that would mean a transport in to the vet. So that is why ER is not the best choice, when vet a neuro's clinic would not require a transport, but can be done over the phone. Pad out the crate with rolled up towels or blanket if you really must transport. Snug him in so that his body will not shift as you take a corner or come to a stop. Really hope the vet on duty at your neuro's hospital will do his job. There is good hope for Blue. First step is pain control so that staying in his recovery suite is a stay in comfort. Did the neuro say the pain was in the neck or the back?Advocate via the vet on duty this evening who can read, Blue's file and therefore can make adjustments to the pain meds. 1) Add TRAMADOL (synthetic opiate) as the general analgesic. every 8 hrs. 2) Add methocarbamol (for muscle spasm pain) every 8 hours 3) Gabapentin for nerve pain 100mgs 3x/day looks good. Just needs to be working with other pain med to address each source of pain. 4) Amantidine is can be useful when all three pain meds are on board. Amantidine itself is not a pain reliever. STOMACH PROTECTION
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. 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 |
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Post by Valrie & Blue on Jun 21, 2020 19:49:58 GMT -7
Nice to meet you Paul, my name is Valrie. I appreciate your response, I am so hurt to watch him in pain. He is resting now. I gave him another dose of Gabapentin. I will call tomorrow and see if they can give me medicine that will help him relax more and stay comfortable throughout the day. The worse part is when I take him out and pack him outside for potty time. He is shaking and shivering the whole time and then it takes him awhile to relax when we come back and I put him back in his cage on his blanket and I'll rub him for awhile. Today he tried to bite me when I was trying to move and hold his legs for him but I know it's because he was in pain. I will make sure to ask all your questions when talking with the nuerogolgist office tomorrow. I have an app with the regular vet, but I'm going to cancel it and see if changing the medicine will help him.
I have Methocarbamol 500 mg doseage was 1/4 of tablet every 8 to 12 hours and Carprofen 25 mg 1/2 tablet every 12 hours, but I was told to discontinue the medicine. on what date? What is the Amantadine for?
[Moderator's Note. Please do not edit
15lbs
Carprofen stopped on 6/19: NO 5-7 days washout given before starting pred.
prednisone as of 6/20 7.5mgs 1x/day for 5 days, then 6/25 test taper for _ pain/ _neuro
gabapentin 100mgs 3x/day
amantadine 100mgs 1x/day
needs GI tract protector, Pepcid AC, on board w/prednisone! + sucralfate for no washout days]
Gabapentin 100 mgs been taken since 6/16/2020 every 8 hours,
prednosone 5mg 6/20/2020 1st 5 days 1 1/2 tablet daily, then give 1 tablet by mouth once daily for 3 days, then give1/2 tablet by mouth once daily for 3 days, then give 1/2 tablet by mouth once every other day till gone
Amantadine 100 mg 6/18/2020 one a day
Below is what I recieved from the specialist unfortunately I am not able to afford the MRI or surgery for my precious Blue😢
THE ANIMAL NEUROLOGY AND IMAGING CENTERAT THE HEART OF TEXAS VETERINARY SPECIALTYCENTER115 OLD SETTLERS BLVDROUND ROCK, TX 78664512-744-4644www.theanic.comwww.facebook.com/theanimalneurologyimagingcenterClient: Valerie Humphrey Referring Veterinarian: Meghan MinorPatient: Blue Hospital: VCA Hometown Animal CarePatient ID: 73296 Phone: (512) 251-2242Age: 3 Yrs. 3 Mos. Fax: (512) 251-7866Gender: Neutered MaleBreed: Chihuahua MixWeight:Date of Discharge:DIAGNOSIS: Open for T3-L3 myelopathy, suspect intervertebral disc diseaseFOLLOW-UP/AT HOME INSTRUCTIONS:
Based on my exam today, Blue likely has compression of the spinal cord somewhere betweenhis shoulders and his hips. Given Blue's breed, age and history, I suspect intervertebral discdisease as the underlying cause. Without further diagnostic evaluation with an MRI of the spine,I cannot definitively rule out other causes such as a mass (tumor), infection/inflammation or astroke, although these are considered less likely.Intervertebral disc disease (IVDD) develops when the central part of the disc dries out and failsto act as a shock absorber. Following this degeneration, normal activities such as running andplaying can lead to extrusion of the diseased disc into the spinal canal. Following disc extrusionthere is both compression and swelling of the spinal cord that can lead to signs ranging inseverity from pain without neurologic deficits to complete paralysis. Dogs that have sufferedone bout of IVDD have a 15-25% chance of experiencing another episode in the future dueeither to herniation of disc material at a different site or in some cases herniation of additionalmaterial from the original site. In some cases recurrent episodes can be managed withoutsurgery. For this reason if you ever notice a recurrence of back or neck pain or if Blue beginshaving more difficulty walking again, the best thing to do is immediately re-institute cage rest(see below) and bring him to a veterinarian for re-evaluation as soon as possible.If Blue's pain worsens, he is unable to walk, and/or urinate - please contact us immediately orseek emergency care as this is likely a sign that his case has progressed and requires additionaldiagnostics and treatment.Monitoring and Care:Blue needs strict exercise restriction for the next 4-6 weeks given the likelihood of IVDD.Though this may seem harsh, it is the most important part of his recovery. We suspect there iscurrently a hole in the outer layer of Blue’s diseased intervertebral disc that will take 4-6 weeksto heal. If he becomes too active too quickly he could herniate more material causingadditional compression of his spine, potentially requiring surgical intervention. Restricting Blue’sactivity will become most important as he starts to feel better and wants to be active. Please
THE ANIMAL NEUROLOGY AND IMAGING CENTERAT THE HEART OF TEXAS VETERINARY SPECIALTYCENTER115 OLD SETTLERS BLVDROUND ROCK, TX 78664512-744-4644www.theanic.comwww.facebook.com/theanimalneurologyimagingcenter keep him confined to a dog crate when he is not out for eliminations. Additionally, you willneed to prevent any jumping, running or rough play.When taken outside to eliminate, Blue should be on a short leash at all times with a sling/towelused to support his hind end. If Blue does not urinate in 12-24 hours please call us as this couldbe an indication of a serious problem. After the initial 4-6 week period, Blue can begin to beslowly re-introduced to his regular exercise regimen, as he is able. In the long term avoidinghigh impact activities such as jumping on or off furniture and trying to keep Blue at a lean bodyweight are things that may help reduce the risk of recurrent back pain or weakness.
Physical Therapy: It is recommended that you provide Blue with passive range of motion to helpkeep his muscles and joints relaxed and flexible. The exercises are described below:-Start by flexing and extending each leg 10-12 times. The goal is to make sure that you aremanipulating each joint.-Next, move the leg in a bicycle motion 10-12 times per leg.When performing range of motion exercises, please perform joint compressions of all jointsincluding the stifle (knee), hock (ankle), elbow and carpus. To perform these exercises, simplycompress the bone above and below each joint together to help supply nourishment tocartilage and to stimulate nerve receptors in the joint capsule. Compressions should be gentleand should not cause any pain. These exercises can be performed as often as possible to helpimprove Blue’s rehabilitation outcome.**Call or bring Blue to a veterinarian immediately if he is showing signs of neurologic declinesuch as weakness in his front legs, loss of strength in his pelvic limbs, progressive pain, or if hehas any vomiting, diarrhea, lethargy, decreased appetite, or trouble breathing.
MEDICATIONS: Discontinue methocarbamol and carprofen at this time
Gabapentin (100 mg capsules): Please increase to 1 capsule by mouth every 8 hours as neededfor pain. May cause sedation.
Prednisone (5 mg tablets): Starting evening of June 20th, please administer 1 and 1/2 tablet bymouth once daily for 5 days, then decrease to 1 tablet once daily for 3 days, then decrease to1/2 table once daily for 3 days, then decrease to 1/2 tablet once every other day until gone. DONOT discontinue abruptly or give in conjunction with a non-steroidal medication (i.e. Rimadyl,Metacam, or aspirin) as this could lead to gastric ulceration. Please contact a veterinarian
if Blue starts vomiting, has diarrhea or dark, tar colored stools. This medication isa steroid and may increase thirst, urinations and appetite.
Amantadine (100 mg capsules): Please administer 1 capsule by mouth once daily until gone.May cause sedation.RECHECK:1-2 weeks: Please schedule a recheck examination in 1-2 weeks to reevaluate Blue's neurologicstatus and discuss prognosis for continued recovery.4-6 weeks: Please plan to schedule a recheck in approximately 4-6 weeks to re-evaluate Blue'sneurologic status and discuss the transition back to normal activity if indicated at that time.Thank you for entrusting us with Blue's care today. If you have concerns or questions, pleasecall 512-744-4644.Sincerely,Lara Curtis DVM, Practice Limited to Neurology
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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 21, 2020 20:31:37 GMT -7
Board Certified veterinarian specialists have these credentials after their name DVM, ACVIM (neurology) or DVM, ACVS No credentials, then they can't call themselves specialists. Lara Curtis, DVM, may be waiting to take her board exam and in order to receive her diploma and be able to use the speciialist's credentials. The three way combo of methocarbamol, tramadol and gabapentin are prescribed as "the" combo of pain med with a disc episode. You can browse the CONSERVATIVE BOARD to see this is how vets who know IVDD with dogs under conservative treatment use these pain meds. All three together. What date did carprofen stop? This is incredibly important information. If there was not a 5-7 days of washout BEFORE pred started, Blue's GI tract is in serious danger. He needs Pepcid AC to suppress acids on board pronto! And he needs a 2nd GI tract protector called sucralfate from your vet. Have you been doing the PT mentioned in the Round Rock report. If so STOP AT ONCE! No PT till off all meds and no more pain. The single most important care right now is the 100% STRICT rest. Only outside of the recovery suite for potty time. NO PT at all. Eats and drinks inside the suite. Read about amantidine, sucralfate and famotidine to be up to speed on each of your dog's meds. Can't recommend a better veterinary website than this one to do your reading: www.marvistavet.com/pharmacy-center.pml |
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Post by Valrie & Blue on Jun 22, 2020 6:19:40 GMT -7
Good morning,
Carprofen was discontinued on Friday 6/19/20 the [carprofen] last day he had it. He did go out today 6/22/20 and pooped and peeped he even tried to run. I got him on his leash when we go out and there was not really any shakey/shivering today.
I did give him a 1/4 of a piece Methocarbamol last night and I think that helped him.
[Moderator's Note. Please do not edit
15lbs
Carprofen stopped 6/19: 5-7 days washout is required before starting pred.
prednisone as of 6/20 7.5mgs 1x/day for 5 days, then 6/25 test taper for _ pain/ _neuro
gabapentin 100mgs 3x/day
methocarbamol 125mgs ?x/day
amantadine 100mgs 1x/day
needs GI tract protector, Pepcid AC, on board w/prednisone! PLUS sucralfate due to no 5-7 days washout from carprofen! !]
Of course when we come in from potty breaks he is a little over excreted and needs to calm down and rest and he does after awhile. He is resting in his cage/ suite right now. He nibbled a little on some food and had some a little water. When I take my break today I will run out to the store and get some pepcid ac for him and give it to him. The neurology dept is in on Tuesday i did leave a message asking for pain medicine and the other stomach medicine you mentioned. Just waiting on them to call back.
I truly appreciate your time and all the great information you have provided me it has helped me in this stressful time ❤
I have discontinued the PT as well.
Love,
Valrie Humphrey
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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 22, 2020 6:42:52 GMT -7
Valarie, so glad to hear the Methocarbamol helped with pain. Can you be clear that there no signs of pain at all dose to dose of pain medications now with the addition of methocarbamol: ◻︎ 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 1) How many times a day do you give prednisone at 7.5mgs?
2) How many times a day are you now giving methocarbamol 125mgs?
Carprofen stays in the body for 5-7 days. Therefore Rxing prednisone with no days of washout means both carprofen and prednisone are in the body at the same time. If deemed an emergency to try and prevent further loss of neuro functions it is a high consideration when switching to prednisone to double protect the stomach with not just Pepcid AC, but adding sucralfate. Experts explain to vets why the need to protect the stomach lining. Prednisone is a a type of glucocorticoids The PT you were giving may have caused a set back to the disc, maybe increased damage to the disc? At some point was pain in control and then more pain surfaced? That would indicate new pain, and likely some new damage to the disc that was trying to heal. This is important information, let us know what you observed.
Hope to hear you were able to get a prescription for sucralfate. It works in a different way to protect the GI tract than Pepcid AC (famotidine). Learn what the timings is for sucralfate with food, with Pepcid AC: marvistavet.com/sucralfate.pml
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Post by Valrie & Blue on Jun 22, 2020 7:18:23 GMT -7
1) How many times a day do you give prednisone at 7.5mgs? Once a day
2) How many times a day are you now giving methocarbamol 125mgs? The bottle says every 8 to 12 hours
With the PT I was not doing anything besides rubbing/ massaging his legs. He was trying to bite me and yelping in pain when I was trying to use a sling I made out of an ace bandage I only tried that once. I will wait for the vet to call because I need more gabapenetin as well and I will ask about the other medicines you mentioned to make sure I'm protecting his GI tract.
Thank you
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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 22, 2020 7:37:00 GMT -7
Wanting to know exactly how many times a day you are actually giving:
Methocarbamol at 125mgs ?x/day It should be every 8 hrs to keep the pain med level enough to prevent muscle spasm pain dose to dose.
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Post by Valrie & Blue on Jun 22, 2020 19:52:24 GMT -7
I've been giving it [Methocarbamol] only once a day at bed time. I didn't want to over medicate him
[Moderator's Note. Please do not edit
15lbs
Carprofen stopped 6/19: 5-7 days washout is required before starting pred.
prednisone as of 6/20: 7.5mgs 1x/day for 5 days, then 6/25 test taper for _ pain/ _neuro
gabapentin 100mgs 3x/day
methocarbamol 125mgs 1x/day
amantadine 100mgs 1x/day
needs GI tract protector, Pepcid AC, on board w/prednisone! PLUS sucralfate due to no 5-7 days washout from carprofen! !]
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jun 23, 2020 4:29:49 GMT -7
Hi, Valrie Getting the correct meds on board is a crucial part of conservative care. Most times it takes all three pain meds - Tramadol as a general pain med, Gabapentin for nerve pain and Methocarbamol for the pain of muscle spasms - to get the severe pain of IVDD completely under control. All three of these pain meds have a short half life and work best when given 3x/day. Once you have Blue's pain completely under control, with no sign of pain appearing from one dose of pain meds to the next, then you know you have the correct meds on board. If not, then the meds need to be adjusted again. It's very unlikely that giving Blue Methocarbamol once a day will work for a full 24 hours. I see that the vet discontinued Methocarbamol at one point. Do speak to the vet ASAP this morning to get Methocarbamol back on board and do give it 3x/day. That dosage will not be over medicating Blue so please don't be concerned about that. If Blue's pain is still not completely under control with the addition of Methocarbamol 3x/day (still showing any sign of pain at all), then do speak to the vet about adding Tramadol. Pain should be under control within one hour of giving the meds and remain completely under control from one dose to the next. If that doesn't happen, call the vet ASAP. And it's also very important to get a stomach protector such as Pepcid AC (Famotidine) PLUS Sucralfate on board ASAP so speak to the vet to strongly advocate for that ASAP this morning. Once the meds are correct, Blue will be able to rest and heal in comfort. Have no patience with pain as it does hinder healing and there's no reason for Blue to be miserable. I see, too, that the vet recommended 4-6 weeks of strict crate rest. Please be aware that it takes a full 8 weeks of strict crate rest for a damaged disc to heal and form secure scar tissue. Too much movement before the disc has completely healed and the damaged disc can re-tear or rupture, causing more pain and possibly more nerve damage and Blue would be back to square one. The best thing you can do is to learn all that you can about IVDD as soon as you can. Not all vets have seen enough cases of IVDD to have full knowledge of its treatment. However, YOU can become a mini-expert and can then recognize when you've been given incorrect information. Read all that you can, starting on this page, clicking on each of the orange links: www.dodgerslist.com/healingindex.htmPlease let us know what the vet says after speaking to them this morning. Prayers that Blue's pain will be brought completely under control today. |
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