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Post by ROGERmom1957 on Aug 29, 2020 14:29:18 GMT -7
Can someone recommend a neurologist and give average costs of imaging, surgery, treatments, etc for IVDD around the Metairie, LA. area?
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Post by Romy & Frankie on Aug 29, 2020 14:58:08 GMT -7
I looked through member recommendations and did not find any posting in Louisiana. Perhaps one of our members will see this and have a recommendation.
We also have a link here that may help you:
Do you feel comfortable sharing your dog's IVDD story with us? We would like to hear it.
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Post by Julie & Roger on Aug 29, 2020 14:58:51 GMT -7
QUESTIONS ☆ 1 currently pain? Yes ☆ 2 32 lbs Gabapentin 200 mg 3x/day 1/2 5-325 Hydro/Acet 3x/day Trazadone 50 mg (to relax him as needed usually 2x day) Prednisone 10 mg 2x day started 16 days ago - have not started taper yet because of pain still: reluctant to move and yelps when he is picked up He is not on Pepcid. He has no issues that would prevent him from taking it as far as I know
[Moderator's Note. Please do not edit 32lbs Aug 29 STRICT rest started Prednisone as of 8/13 negated 16 days due to lack of STRI CT rest as of 9/29: 10mgs 2x/day for ? days, then pred taper test: _pain /_neuro Gabapentin 200mgs 3x/day Hydrocodone /acetaminophen ?mg 3x/day trazodone 50 mgs 3x/day needs GI tract protector, Pepcid AC, on board w/prednisone!
☆ 3 -- Eating and drinking fine. Poops and pees fine ☆ 4 Beagle. His name is Roger. My name is Julie ☆ 5 Xray at vet - suggested IVDD - radiologist indicated same - referred to neurologist if not getting better - have not contact neurologist yet -neurologist is 2.5 hours away - was going to try conservative first?
-- Gen DVM
☆ 6 CONSERVATIVE treatment: August 20 conservative - meds ☆ 7 Full bladder control - even raises leg to urinate ☆ 8 When pain meds are working, he walks almost normal with head sometimes raised and wags tail.
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Post by Romy & Frankie on Aug 29, 2020 15:49:27 GMT -7
Welcome to Dodgerslist, Julie. We are glad you have joined us. 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: dodgerslist.com/2020/04/18/hope-quality-life/Roger is in pain so his pain meds must be adjusted. We know he is in pain because he is reluctant to move and yelps when he is picked up. I see among his pain meds is Hydrocodone-Acetaminophen. This is a quote from an article in Veterinary Anesthesia & Analgesia Support Group "Codeine is not a recommended analgesic for dogs or cats. It is generally only available in combination with acetaminophen (Tylenol) which makes it completely unsuited to feline use. Its use in dogs is discouraged as most dogs lack the CYP2D6 enzyme primarily responsible for the conversion of codeine to morphine, its most active metabolite. That being said, there may be some analgesic value to codeine in dogs via the C6G metabolite.
The general pain med we see most often prescribed is tramadol. Another med that we have seen work well with the tramadol and gabapentin is Methocarbamol. Methocarbamol works on painful muscle spasms often seen in IVDD. Please let your vet know as soon as possible the signs of pain you are seeing in Roger and ask for the medications to be adjusted. Tramadol, gabapentin and Methocarbamol prescribed 3X a day are the meds we most commonly seen to provide relief of pain in dogs on this list. When pain meds are right pain relief is seen within an hour and there is no pain between doses. Pain will only slow the healing process.
All anti-inflammatories cause excess stomach acid which can lead to serious stomach acid. A stomach protector like Pepcid AC helps to reduce the chances of damage. Our dogs have enough to deal with without adding stomach damage. When you speak to your vet about the pain meds, please ask the vet if Roger has any health issues which would prevent use of Pepcid AC. If the answer is no, Pepcid AC can be purchased in any grocery or drugstore.
Since Roger has minimal neuro deficits, he can walk and wag his tail, he is an excellent candidate for Conservative treatment. 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.
STRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times
If you can, carry Roger to and from the recovery suite to the potty place and then allow a very limited number of footsteps If Roger is to heavy (32 lbs) to carry it is still important that the amount of movement to the potty place be minimized. Try a pee pad right outside the crate. At first, he might be reluctant to use it. If so, you can put a paper towel with another dog's urine on the pad which may encourage Roger to urinate. My dog needed this encouragement.
Did your vet mention his neck being painful? His painful symptoms like holding his head in an odd position and not wanting to bear weight on a front leg is often the sign of a neck disc issue. We have some tips on caring for a neck disc here: By learning more about IVDD you will be able to help Roger more. Be in command of the 4 phases of healing, what to expect with pain, with swelling, disc and nerve healing. We have a lot of info here: dodgerslist.com/healing-the-disc/
At the MAIN WEBSITE, use the SEARCH feature at the top to easily access the treasure trove of more IVDD information.
Please keep us up to date after you talk to the vet.
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Post by Julie & Roger on Aug 29, 2020 15:50:11 GMT -7
Thank you. I posted the answers to the questions you asked on another thread with my name. I am not familiar with forums so I hope I didn't mess anything up. My vet referred me to a neurologist but he is so far away I was looking for one closer. I have been researching a lot on IVDD and found your site today and I have learned a lot already. I have been doing crate rest for Roger, but after reading everything, I am obviously not doing [crate rest] it strictly enough. I hate seeing him hurt.
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Post by Julie & Roger on Aug 29, 2020 17:15:36 GMT -7
Thank you very much for all of the information. I will check on the Pepcid with the vet. We didn't think he would be on the Prednisone for this long. He had a slight problem last November with a little pain and within 3 days on Prednisone and no pain pills, he was back to his normal crazy, active self and we were able to taper down rather quickly.. This has taken me surprise and is very upsetting.
His pain meds have been working for the most part. Today it seemed like they didn't, however, upon reading everything here, I am not restricting his movement enough. I let him walk outside to potty and to eat (I only weigh 100 pounds and I feel like I would do more harm then good if I try to carry him). I will start on strict crate rest. From all of his symptoms and the vet did say it was more than likely his neck. I read your suggestions on that also. Thank you. I really would like to try conservative first for many reasons. The neurologist is several hours away, Roger has severe anxiety riding in a vehicle and now with the pain, it would be worse, and also the expense. However, I will do what I have to do and spend my last dollar if I have to for him. But your site has given me encouragement that he can be helped.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 29, 2020 17:33:29 GMT -7
Julie, sorry to hear your Roger is dealing with a disc episode. Only today you are starting strict rest to ensure the disc doesn't have any more setbacks. It is hard to tell if the pain is due to being undermedicated with pain meds since 8/20 or if he retore the early healing disc without the protection of STRICT rest. Best is to assume he will need a full 8 weeks from 8/29 so his body can self repair the disc. Glad to hear you are reading and getting up to speed on IVDD. Your knowledge will help to protect him and give him the best opportunity to heal properly. I like that! Do go over to our Main Website www.dodgerslist.com to start your education. Use the handy orange search bar at the top to find topics of interest as well as going thru the menu bar. Your priority is not necessarily getting a consult from a neuro at this point. With a walking dog, a consult would be if your vet is not comfortable in using pain meds to provide full relieve that surgeons use daily. -- Since you may not be able to carry 40 lbs safely, think outside the box to protect the disc at potty time. Roll a wire recovery suite over to the sliding door by adding casters. Then it is just a few footsteps to potty on the deck. Put some dirt,, straw, etc to potty on. Fence in with an ex-pen so your dog knows there will be no darting off or sniff festing. Castors about $10: If you do not have a deck/sliding door, then consider this idea. Pee pad could also be placed just outside of the recovery suite. Lay down a pee pad WITH the addition of urine from another dog or from your dog on top. Always save a used piece of pee pad in a ziplock bag to use at potty time. Your dog can learn it is ok with you to pee on the pee pad, be sure to use the command “go potty” and when he does give lavish praise. Another idea is to used an ex-pen as the potty area attached to the recovery suite. At potty time open the suite's door so your dog may take a couple of foot steps out to the potty area: .... still writing, pain meds next what to advocate for. Bookmark a thread to receive an email alert when someone has replied
Go to the CONSERVATIVE Board 1. Look for your dog's thread and checkmark it. 2. Look for the white ACTIONS button towards top. 3. Select “Notification Options" from the pull down menu — check mark “NEW POST” change from never to INSTANT email — press the SAVE button. Click the “x” to close the window 4. Next choose the “Bookmark” See the tiny book symbol now!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 29, 2020 17:56:18 GMT -7
Actions to take and what to advocate on behalf of Roger as soon as the vet reopens. Do you have ER service close by just to get the pain meds adjusted and Roger out of pain? ---Since he is in pain, would be worthwhile to try a different pain med approach that may work better. Pain meds working for the "most part" is the same as not working! They need adjustment for round the clock, dose to right up to the next dose relief from pain. There is no one size fits all dogs for pain. It is a matter of adjusting and tweaking by the vet to get is just right for Roger. --- See about an Rx for Tramadol (synthetic opiate) instead of Hydro/Acetam. Tramadol would be Rx'd every 8 hrs. --- Neck disc pain is a great deal of muscle contraction pain. Advocate for methocarbamol every 8 hours. --- Gabapentin 3x/day is for nerve pain. Likely that is doing a good job. --- Keep the vet in the loop with Pepcid AC (famotidine) and confirm no need to adjust dose if he would have kidney or liver issues. Confirm he has no heart issue where another acid suppressor would be the choice, not Pepcid AC. --- Basically not being under strict rest may have negated all prior use of pred if the disc got re-damaged. No way to tell. So it will likely be starting from day one in the count for 8 weeks to heal the disc. And it may well mean starting the count for healing the swollen and inflamed cord from the 7-30 days it may take for pred to finish its job of getting rid of all swelling. ••• Do you have enough pills to go with pred 10mg 2x/day til the vet opens on Monday? Then you can discuss things and advocate for another course of pred as of Aug 29. Maybe the vet will want to try a 7-day course and then taper to test for pain, maybe a 14-day course. All things you can discuss with the vet. Roger has a chance to be a good candidate for conservative treatment, now that he is on 100% STRICT rest inside of a recovery suite to eat and rest. Allow only the fewest of footsteps at potty time by implement an outside the box idea for potty time since you can't carry him. Keep us posted, and let us answer any questions that may come up with your readings over at the main www.dodgerslist.com website.
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Post by Julie & Roger on Aug 29, 2020 18:22:30 GMT -7
If I have no problems tonight or tomorrow, I will call the vet on Monday to discuss everything you have suggested.
No ER Service here. Very small town, but the vet would probably be willing to come out to her office and give me something tomorrow if I need it. I made sure I had meds for the weekend and I also have plenty Prednisone also. Roger is sleeping comfortably now and his next dose of meds is at 9 p.m. I will sleep near him tonight to make sure he is pain free overnight. He has slept all night with no problems since he started on the meds. Thank you again!!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 29, 2020 18:41:38 GMT -7
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Post by Julie & Roger on Aug 30, 2020 4:54:43 GMT -7
Roger had a good night and is resting comfortably in his crate this morning. I have a question that my husband has asked. Is there a brace for the neck that would assist in not moving the neck? I've read about back braces, but read contradicting opinions on them. Thanks.
I printed both of those [PDFs] earlier today [8/29]. Thank you.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 30, 2020 8:31:23 GMT -7
Glad to hear Roger was pain free through out the night. Let us know all pain is fully masked during the day dose to dose of Gabapentin 200mgs 3x/day and Hydrocodone /acetaminophen 3x/day How many mgs of Hydro/Acetamin do you give each dose? Orthotics such as a brace should require an Rx from a board certified neurologist (ACVIM) or an ortho surgeon (ACVS) who is well educated in disc disease. Dodgerslist has contacted our specialists for comment and at this time we do not recommend use of braces unless you are working with a specialist. Implementing these cervical disc tips, will best help Roger along with good pain control round the clock: dodgerslist.com/2020/05/05/cervical-care-tips/
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Post by Julie & Roger on Aug 30, 2020 9:09:52 GMT -7
The prescription is for 1/2 of a tablet 3 times a day.
The [hydrocodone/acetaminophen] tablet is 5-325 [5mg/325mg]. So I guess he is getting 7.5-487.5 per day if that's how it is figured.
[Moderator's Note. Please do not edit 32lbs Aug 29 STRICT rest started Prednisone as of 8/13 negated 16 days due to lack of STRI CT rest as of 9/29: 10mgs 2x/day for ? days, then pred taper test: _pain /_neuro Gabapentin 200mgs 3x/day Hydrocodone /acetaminophen 5mg/325mg tablet: 2.5mgs/162.5mgs 3x/day trazodone 50 mgs 3x/day needs GI tract protector, Pepcid AC, on board w/prednisone! ]
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Post by Julie & Roger on Aug 30, 2020 13:30:59 GMT -7
Roger is obviously feeling pretty good today because he is now whining and barking (not in pain, but to get out crate). He sleeps in a crate every night and was crate trained before but 24/7 is different. I am worried about him moving his neck too much when he barks. I am sitting next to him in the same room. I have tried leaving out the room and he gets worse. I have covered the crate with a blanket. This is basically why I was giving him the Trazadone to make him relax. He has always had to take Trazadone since I have had him for anxiety when taking car trips or if there are a lot of people around. He was a rescue dog that was apparently abused. Any other suggestions or will I just have to let him get used to it?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 30, 2020 14:19:01 GMT -7
There is a need to protect his neck disc.
Did you get a range of trazodone dose in mgs you could give? Are you giving the highest dose in the Rx'd range now?
Did you get a range for the Gabapentin in mg dose? This med can make them sleepy. So if you did get a higher range, you might try that until you can get in touch with your vet on Monday.
MENTAL STIMULATION During recovery time, physical activity must be restricted. Roger can not be allowed expend energy in physical activity to tire himself out. For dogs mental stimulation can be just as tiring. You can help in that department. --- Dr. Becker, DVM, explains "During your dog's mandated rest time for recovery, her movements will be restricted, but her mind will still need stimulation. Teaching her tricks and games appropriate for her temporary physical restrictions will help relieve boredom."
Choose only the activities that can take place inside the recovery suite and activities that do not exceed the demand for 100% STRICT rest for the neck and back. Your dog will be lying on the stomach or maybe quietly sitting. Use your dog's daily food rations as the rewards. Adapt each activity so that it takes place inside of the recovery suite while you sit on the floor in front of the suite's open door. Stop if your dog is getting over excited and displaying rambunctious behavior of too much back movement.
You can make something as simple as eye contact a very rewarding behavior that also acts as a way for your dog to “ask permission” when he wants something. When dogs have a focus and an understanding about how to behave to get what they want, they are much calmer overall. To do this, each time your dog looks at you, say, something like, “Yes!” or use a clicker to mark the second he looks at you, and then give your dog a high-value food reward. [NOTE: for crate resting dogs, shift your body a bit] .... wait for your dog to look up at you again, say, “Yes,” and reward again. Do this exercise 10 or so times and then say, “All done,” and put the treats away. Come back later and do it again until you can see that your dog is really starting to make automatic eye contact in hopes you will say, “Yes,” again and give a reward.
lip lick:
Be aware you might be inadvertently training for unwanted behavior. To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting. So anytime you see unwanted behavior try speaking in your dog's language so he understands to calm down. 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 your dog is sitting or lying down quietly, give a reward of a calm loving "good sit/lie." Soon your dog will see they get rewards by quietly sitting, etc.
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Post by Julie & Roger on Aug 30, 2020 15:07:14 GMT -7
I actually gave him another 50 mg Trazadone and he ate supper and settled down. I have been giving him Trazadone for road trips the 7 years I have him and 50 mg has always knocked him out for most of the day so this is the first time I needed to give more. I believe I am giving the max dose of Gabapentin now but I will check all of these things tomorrow when I contact the vet. I will also be asking her to change the meds to Tramadol and add the Methocarbamol. Thanks again for your input. It has really helped.
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Post by Julie & Roger on Aug 31, 2020 14:07:11 GMT -7
I was able to sit down and talk to vet about everything today.
I was able to get ✙Tramadol and ✙Prednisone and she wrote me a prescription for Methocarbamol.
[Moderator's Note. Please do not edit 32lbs Aug 29 STRICT rest started Prednisone as of 8/13 negated 16 days due to lack of STRI CT rest as of 9/29: 10mgs 2x/day for ? days, then pred taper test: _pain /_neuro Gabapentin 200mgs 3x/day ✙Tramadol ?mg ?x/day ✙Methocarbamol Rx to be filled 9/1 ?mg ?x/day ❓Hydrocodone /acetaminophen 5mg/325mg tablet: 2.5mgs/162.5mgs 3x/day trazodone 50 mgs 3x/day needs GI tract protector, Pepcid AC, on board w/prednisone! ]
She gave me paperwork showing maximum doses of every medicine he is on and told me to possibly stagger meds to prevent pain from returning.
Also talked to her about constipation. I have been giving him pumpkin since he started his meds, but this morning I found that he had a difficult time. I asked if he could take✙ Miralax since I had that here and she said yes, just to start him with a tsp first. He had a really good night and day until I left to go to the vet. I put the television on and snuck out and was only gone for 30 minutes but he got extremely agitated while I was gone and was barking and pawing at the crate door ( I watched him on the camera). Apparently he sensed that I was not in the house. Hopefully, he didn't do any damage to himself. I will try to get someone to pick up the ✙Methocarbamol for me tomorrow.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 31, 2020 14:27:14 GMT -7
Sounds like a good discussion with your vet understanding a need for extended meds!
Did she have an idea to better help Roger be able to relax with trazodone or another med?
How many mgs of tramadol each dose and how often will you actually be giving? What is the max range for Roger?
Has Hydro/Acetamin been stopped, then?
What about Pepcid AC (famotidine)? Does Roger have any health issue that he may not take? If no health issues, did you pick up at the grocery store?
Usually when the right complement of pain meds are on board AND Rx'd for every 8 hours there is not a need to stagger. Makes it easier for you with drug administering that way also! Also keep in mind research studies have found that when when given together gabapentin and tramadol can enhance the effect of each other; therefore, giving the two drugs together may have an advantage for treating inflammatory pain. However there is that staggering option you could discuss if it comes to that.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 31, 2020 14:35:49 GMT -7
The key to plain pureed canned pumpkin being able to address constipation is each kibble meal needs to be soaked in broth or water.
--To loosen the stool, add equal parts water to each kibble meal and soak overnight. At mealtime add a teaspoon of pumpkin for every 10 pounds of body weight (that would be 3 teaspoons for 32lbs Roger) 1x a day.
If you have been doing that and it has not loosened his stool, then maybe try the Miralax. Miralax is the stuff that cleans your gut out prior to a colonoscopy! The concern with anything other than pumpkin is you can't be certain is too loose stool a danger sign of pred damage or just benign laxative.
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Post by Julie & Roger on Aug 31, 2020 14:57:49 GMT -7
100 mg Tramadol - I can give from 1/4 to 1 tablet every 8 hours. I will start tomorrow and discontinue Hydrocone.
Trazadone - I was giving 50 mg and she said I could go up to 100 mg when needed
No health issues to prevent famotidine. I had some here so I will start giving him.
[Moderator's Note. Please do not edit 32lbs Aug 29 STRICT rest started Prednisone as of 8/13 negated 16 days due to lack of STRI CT rest as of 9/29: 10mgs 2x/day for ? days, then pred taper test: _pain /_neuro Gabapentin 200mgs 3x/day Tramadol 100mg tab: 100mg 3x/day Methocarbamol Rx to be filled/started 9/1 ?mg ?x/day trazodone 100 mgs 3x/day ✙ Pepcid AC (famotidine) 15mgs? 2x/day ✙ Miralax try one dose]
I am already adding pumpkin and soaking his kibble so I may try one small dose of Miralax.
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