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Post by Javier & Carter on Sept 13, 2020 3:49:38 GMT -7
[Original subject line: Carter ShihTzu neck pain ] Hello! Firstly, I want to thank this forum. It saved me three years ago when my dog had a terrible IVDD episode. It was so helpful and supportive to read what others have been through and the help and suggestions of the admin. My dog probably would have been put to sleep if I didn’t tell the vet what I learned on here. Thank you! On 9/12 my dog came in from outside acting weird. Tail down, walking funny and shaking. I immediately had flashbacks to the terrible time 3 years ago, I gave him a 100mg Gabapentin and rushed him to the vet. The vet did an Exam and said It did not seem Carter was in that much pain but to give him a 100mg Gabapentin every 12 hours and Methocarbamol 500mg 1/2 pill every 6-8 hours. Carter is still able to walk and hold his bowls and urine, but not interested in food at all and is very lethargic. About 12 hours since the vet visit, I felt like something wasn’t right and I took him to the emergency vet [9/13]. They concluded that he does have pain in his neck from IVDD. Gave him a shot of morphine and prescribed Carprofen 25mgs 1/2 a pill every 12 hours and struck rest. He is not interested in any type of food, so I couldn’t give him the Carprofen early 9/13. To conclude: He is prescribed 100mgs Gabapentin 1 every 8 hours 500 Methocarbamol 1/2 pill every 6-8 hours Carprofen 25mgs 1/2 pill every 12 hours but needs food with it. 22 pound ShihTzu Symptoms- keeps holding his head all the way up, shaking some, lethargic and withdrawn concern is that he will not eat anything or drink water (I have tried all types of food and he won’t even smell it) [Moderator's note: please do not edit
22 lbs.
Carprofen as of 9/13: 12.5mg 2x/day for 14 days then 9/27 stop test: _pain/_neuro
Methocarbamol 250mg 3x/day
Gabapentin 100mg 3x/day
Pepcid AC since 9/13: 10 mgs 2x/day]Will he not feel better until I am able to get him to eat and with the Carprofen? he has been on strict crate rest starting 9/13 around midnight. Any advice would be greatly appreciated, just like all the other parents on here, this is ripping my heart out that it may get worse and he could have the same pain as the last episode. The last episode was his neck and in his lower back, yelping in pain, truly heartbreaking. Thank you admin for all the support you give to this group. It’s truly saved lives! |
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Mary & Mila
Helpful Member 
FEMALE— DACHSHUND
Posts: 218 
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Post by Mary & Mila on Sept 13, 2020 4:23:15 GMT -7
hi there, Welcome to Dodgerslist. So glad that we were of assistance to you previously. My name is Mary, what is yours? Sorry to read about Carter's current issues. As Carter should be taking Carprofen you will need to add a tummy protector. Here at Dodgerslist we recommend Pepcid AC . Stomach protection
Pepcid AC 3 reasons why: dodgerslist.com/2020/05/06/stomach-protection/So we have a challenge now, how to get Carter to take his meds.... the only suggestion I can make is one you may have tried already which is putting the pill in the middle of a piece of soft cheese or chicken or other soft food he likes, see if you can tempt him with a reg piece first, so he's not suspicious, then give the one with the med and end with a regular one again. You can't force him because any forced movement may injure the neck more. Also if you feed him kibble it would be best to soften it with warm water for now as chewing could also cause him pain. I hope one of the other mods may be able to offer other ideas when they see your post, so keep checking. I'm assuming he is on crate rest now and that it's all set up for him  Can you confirm that the water and food dishes are raised in the crate? As it would be easier for him to eat if they were at head height. **  Please check this link out. It will refresh your knowledge on caring for a dog with neck disc issues. dodgerslist.com/2020/05/05/cervical-care-tips/?highlight=neck%20issueskind regards Mary |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Sept 13, 2020 4:29:06 GMT -7
Welcome back to Dodgerslist. My name is Marjorie - what's yours? You have a pain emergency that must be addressed ASAP today. Carter is still in pain and his pain meds must be adjusted ASAP. Please call the hospital where he was last seen. Any vet there can pull his records and adjust his meds. How often are you giving the Methocarbamol - every 6 or 8 hours? Advocate for the addition of Tramadol. It often takes all three of these meds at an aggressive dosage to get the severe pain of a neck injury completely under control. There should be no sign of pain within one hour of giving the new course of meds and no sign of pain from one dose to the next. Once Carter's pain is brought under control, you should be able to give him the Carprofen. It's very important that he start that ASAP as that is the anti-inflammatory that will get the swelling down. It's that swelling and extruded disc material that's pressing on the nerves of his spine that's causing the pain and can lead to nerve damage so please be sure to get him started on that ASAP. Most likely the first vet did not see much pain upon exam due to the fact that you gave Carter a pain med before the exam. PEPCID AC: Anytime a dog is taking an anti-inflammatory, stomach protection must be added. 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). i.ibb.co/DCN9611/91x-Aj-s00z-L-SY355.jpgDoxie weight dogs: 5mg Pepcid AC (famotidine) every 12 hours. NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory. www.1800petmeds.com/Famotidine-prod11171.htmlThere are several other things that you need to do to help Carter's neck heal, such as softening hard kibble, raising food/water dishes. More info here: dodgerslist.com/2020/05/05/cervical-care-tips/For how many days has Carprofen been prescribed for?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. Super tried and true tips for setting up the recovery suite, the mattress and more! —> dodgerslist.com/2020/05/14/strict-rest-recovery-process/STRICT means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy whys: dodgerslist.com/2020/04/22/chiropractic/?highlight=chiropractic◼︎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 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! i.ibb.co/K7HNj10/slingwalk.jpgPlease let us know what the vet says after speaking to them this morning. Healing prayers for Carter. |
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Post by Romy & Frankie on Sept 13, 2020 6:11:51 GMT -7
I would like to add my welcome to Mary's and Marjorie's. It is more difficult to give the meds when the dog is not interested in food. This video shows some ways you can try to give Carter his meds. At about 1:15 minutes into the video there is a discussion on how to pill without food.
Carter's lack of interest in food and drink makes it very, very important that he start the Pepcid as soon as possible. Sometimes when dogs are in pain they will not be interested in food but sometimes it can be a sign of stomach damage. Excess stomach acid that can cause stomach damage is often associated with IVDD. The reasons for this is that pain and body changes of this disease can cause stress. This is similar to humans getting ulcers when under stress. In addition to this, anti-inflammatories such as Carprofen also cause excess stomach acid. Our IVDD dogs have enough to deal with without adding stomach problems.
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Post by Javier & Carter on Sept 13, 2020 6:30:28 GMT -7
Thank you three so much for your help. This morning 9/13, (after sitting up just watching him sleep all night) I carried him to the kitchen and he’s looking at me wagging his tail, like where’s my food? I gave him some non-pill deli slice pieces and he gobbled them up, and the Gabapentin and Methocarbamol no problem. He then ate a bowl of lean beef and rice (allergic to chicken). So I was able to give him the pepcid and Carprofen!
The Carprofen is for two weeks, doesn’t taper off? Do you have any thoughts on that?
Since he is able to eat and does not seem to still be in pain, would the Tramadol still be necessary as a precaution?
I am giving the 250mgs Methocarbamol every 8 hours along with the Gabapentin 100mgs. Would you suggest every 6 hours for Methocarbamol?
Thank you all so so much for your support. It feels so good to have this forum.
My name is Javier, pronounced (J-V-air), the same as the male dominate Spanish name Javier (Havier)
Thanks again!
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Post by Romy & Frankie on Sept 13, 2020 6:52:41 GMT -7
Very good news that Carter is now eating and not showing any signs of pain. Now he can heal in comfort.
Carprofen is an NSAID type of anti-inflammatory and does not have to be tapered. Only a steroid type of anti-inflammatory, like prednisone, needs to be tapered. Pepcid AC would be needed as long as he is on the anti-inflammatory.
No dog should not be taking any more meds than necessary. These are the signs of pain to look out for: -shivering, trembling -yelping when picked up or moved -reluctant to move much in crate such as shift positions or slow to move -tight tense tummy -can’t find a comfortable position -arched back -holding front or back leg flamingo style not wanting to bear weight -head held high or nose to the ground -Not their normal perky selves Full pain relief is expected in 1 hour and stays that way between doses.
If Carter is showing none of these signs and is pain free without tramadol, there is no need for tramadol. If he is pain free, there would be no need to increase the Methocarbamol to every 6 hours. However, if he is showing any signs of pain, discuss adding tramadol with your vet. Tramadol in addition to methocarbamol and gabapentin is the combination we have most frequently seen provide relief during an IVDD episode. |
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Post by Javier & Carter on Sept 14, 2020 16:30:56 GMT -7
Thank you for the information!
Carter is doing great, thank goodness. Acting totally normal. I am just wondering, how many days do I continue all the medication for? Is there a timeframe where I should test out spacing the timing to every 12 hours instead of 8 for the gabapentin and methocarbamol? I do not want to anytime soon, but I’m afraid the vet will say he can go off of them sooner than later since he does not show any signs of discomfort or limited ability to do anything. Last time this happened was much worse and I took him off the meds after 2 weeks and it got really bad. Granted, I was unaware of the necessity of crating and no activity.
Thank you!
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Sept 14, 2020 20:01:57 GMT -7
Javier, let us know that Carter eats inside of his recovery suite with bowls attached at head height. So basically he is out of the suite just at potty times. Check it out— good stuff!The bowl tip and many more tips come from: dodgerslist.com/2020/05/14/strict-rest-recovery-process/ Pepcid AC...do you have that on board yet? If not, what is the stumbling block? Please do read all about stomach protection: dodgerslist.com/2020/05/06/stomach-protection/It is good to know all about Carter's treatment. In fact it is your job to know as that is how you play an integral part of Carter's treatment and care, understand what what your vet is communicating and if you don't, then ask more questions. Anti-inflammatory drugsThe KEY medication is the anti-inflammatory drug. While it works to resolve pain in 7-30 days, pain meds work to mask pain to provide full comfort. Please do up your anti-inflammatory knowledge and see if you have the tools downloaded to track, to see patterns, to avoid dangerous detour off the Conservative road. All that and more is here: dodgerslist.com/2020/04/22/healing-swelling-inflammation/Your vet took a guess, as all vets must do, as to how long an anti-inflammatory course to prescribe. Some choose 7-days. Your vet chose 14 days. On the stop of Carprofen on Sep 27 will be the time for the pain masking pain meds to be stopped or backed off. Your job at home will be to monitor if there is any hint of re-surfacing pain and immediately report to the vet.
Pain on the test stop =
another carprofen course and pain meds + Pepcid AC
Which does your vet want on 9/27? -- Full stop of all pain-masking pain meds (methocarbamol and gabapentin) or.... -- the backing off of pain meds? Plan BWith any test stop, 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! No Pain on the test stop = no need of any meds... just finish out the 8 weeks of crate rest for the disc to heal. |
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Post by Javier & Carter on Sept 15, 2020 7:38:52 GMT -7
Carter has been having variant forms of diarrhea the past two days, starting the night of 9/13. This morning it was more solid so I thought it was getting better and just because of the anxiety, changing foods from his regular kibble to beef and rice etc. This morning he was not interested in food at all, had to force his pills. Gave him ✙Pepcid 30min before carprofen (1/2 of a 25mg pill). In two hours he then threw up. I called the vet and they are in surgery until this afternoon. Any advice on what to advocate to the vet this afternoon? He does not seem to be in pain. This gabapentin and methocarbemal were both given to him 4 hours prior to throwing up.
Thank you!
[Moderator's note: please do not edit
22 lbs.
Carprofen as of 9/13: 12.5mg 2x/day for 14 days then 9/27 stop test: _pain/_neuro
Methocarbamol 250mg 3x/day
Gabapentin 100mg 3x/day
✙Pepcid AC as of 9/13: 10mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Sept 15, 2020 7:59:41 GMT -7
Javier, we are missing the detailed information about the med list that makes it impossible to correctly comment. What date did you begin the Pepcid AC? Are you giving 10mgs Pepcid AC TWICE a day? 2ND PROTECTOR NEEDED For most dogs the Pepcid AC alone will suffice to protect. For those dogs who are still showing signs red flag GI tract damage, THEN the vet adds in a 2nd protector called SUCRALFATE. There is a time to sucralfate with food and with Pepcid AC. Homework reading as prep for advocating for sucralfate RX plus you knowing the timing: marvistavet.com/sucralfate.pmlCHANGE IN FOOD issue When on the big gun meds, it is never a good idea to be changing foods. Now there is confusion if this is a very serious GI issue or mearly change in food. One must NOW assume it is danger of meds and to get that sucralfate on board, now today. When there is the very first of early red flag signs of GI damage (not eating, loose stool, vomit — think double protection not change in food. Better to withhold his regular food for 12 hrs and then try to give a small amount of same food. See if he holds it down and then try another small amount. All the while with 2nd protector sucralfate on board. Dogs do not digest rice. It can become gassy upsetting stuff sitting in the gut. ANY PROBLEM at THE WEBSITE? Just checking, is there is a problem accessing the Dodgerslist main website we need to fix? Sorry if that is the case that you could not access the information to prepare yourself just in case. The link from there contains the signs to watch for with GI issues, all about sucralfate and when to advocate for it, etc. The GI tract damage and how to protect link: dodgerslist.com/2020/05/06/stomach-protection/ |
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Post by Javier & Carter on Sept 15, 2020 8:39:26 GMT -7
I started the Pepcid 9/13 along with the carprophen. 10mg twice a day 30 min before carprophen. I gave him the beef and rice bc the vet said it would be easier on his stomach. But the past two days he’s been on his regular but moistened food. I will advocate for the sucralfate with the vet. Thank you!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Sept 15, 2020 10:26:55 GMT -7
Javier, thank YOU for the missing med list info. Hope to hear sucralfate is on board soon now. Let us know how things are going upon dosing with sucralfate. Sucralfate forms a gel coating over any damaged areas of the stomach lining. The Pepcid AC lessons stomach acids that can cause bleeding ulcers. That is why not eating, vomit, diarrhea are red flag signs to act quickly to get sucralfate on board. Must read details about sucralfate: www.marvistavet.com/sucralfate.pml |
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