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Post by Diane & Bugs on Dec 28, 2020 11:45:25 GMT -7
Paula,
Bugs is experiencing another disc episode. I have him on crate rest and I have started 2.5mg Prednisone 2x a day. This has just started. I have tramadol, methocarbamol and gabapentin avail here. Should I go ahead and start those as well? He has complete feeling in all limbs. He is not trembling or panting. If I do feel him and he is slightly trembling I have given him a Tramadol only. He has complete function of bladder and bowels. Appreciate your guidance again.
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Post by Diane & Bugs on Dec 28, 2020 12:54:39 GMT -7
[Orig subject line: Bugs has all the signs of another disc]
This began on 12/26. He is on strict crate rest since that time. He is 11 lbs
Meds: 25mg Prednisone 2x day started 12/27/20
Famotadine 2x a day - 30 mins prior to pred
Tramadol 25 mg every 8 hours
I also have methocarbamol and gabapentin if needed. Unsure whether to add them or not.
[Moderator's Note. Please do not edit
11lbs
Prednisone 5mg tab as of 12/27: 2.5 mgs dose 2x/day for ? days, then test taper
tramadol 25mgs 3x/day
famotidine ?mgs 2x/day]
NO nausea, no vomitting, eating and drinking normally.
Bugs is a terrier mix. Diagnosed with IVDD by a ACVIM neurologist. Two surgeries for discs - L4-L5 hemilaminectomy 9/19, T12 - T13. April 2020, Conservative treatment for neck disc June 2020
Bugs walks very slowly with tail down. is not wagging his tail. Walks on all four legs without any favor.
bathroom breaks normal.
He is sullen and not himself at all. Good appetite. Looking to conservatively treat again.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,561
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Post by PaulaM on Dec 28, 2020 13:07:20 GMT -7
Diane, oh gosh, sorry to hear of another episode. What date did you see the vet? Did the vet Rx the Prednisone? Check the bottle, for the size of a whole pred tablet in mgs. Then what portion of the pred tablet are you to give? For how many days will pred at the ?mgs dose (2x/day) be given? Is tramadol 3x/day fully covering pain dose to dose? Famotidine: ?mgs are you giving 2x/day? What are the details on the Rxs for Methocarbamol and gabapentin? How many mgs dose? How often to give? Which of these signs of pain do you currently see since being on pred and tramadol: SIGNS OF PAIN: ◻︎ 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
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Diane, I just found your other post which clears up the dose of Prednisone being given.
Do fill us in on the other questions I have asked above. IF the vet just Rx'd the prednisone for this episode, then for how many day is Bugs to take 2.5mgs 2x/day?
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Post by Diane & Bugs on Dec 28, 2020 13:27:42 GMT -7
Have not been to the regular vet, I know the signs and wanted to get Pred on board. Have appt with new Neuro Jan 20th first avail. ACVIM I had the prednisone here already. 5MG tablets I am to give 1/2 25mg. I do not know the number of days yet, I do know of minimum of 7. trying to get into the regular vet is hard due to Covid here is CA, they keep closing their office for quarantines  If you think he needs to go to the ER I will take him but he is not in any distress, but also not his normal perky self. Famotadine 5mg 2x/day the Tramadol is doing OK - but he is not his normal perky self. The methocarbamol and gabapentin are both RXs from his prior surgery with the Neuro. Methocarbamol 500mg give 1/4 tablet by mouth 3x a day (every 8 hours) _ NOT BEING GIVEN AT THIS TIME Gabapentin 50mg - 1/2 tablet every 8 hours as needed for pain - NOT GIVEN AT THIS TIME AS far as signs of pain - Slower moving than normal , not normal perky self. Everything else good. Any assistance appreciated. thank you Paula I just got an [12/29] appt with BUGS new regular vet. He is seeing her tomorrow and we will go over meds and treatment. I will get back to you with what is discussed. Also have Neuro appt Jan 20th. Thank you Paula Diane |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,561
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Post by PaulaM on Dec 28, 2020 15:25:48 GMT -7
Dianne, good to hear of DVM appt 12/29 for a diagnosis.
Just something to keep in mind. In principal it is not a good idea for an owner to start on an anti-inflammatory on their own when there is a suspicion of a disc episode. The single most important thing is the immediate restriction of movement inside of a recovery suite to prevent further tears of a suspicious disc.
-- Owner dosing of the anti-inflammatory can tie the hands of the vet on his preferred anti-inflammatory should the diagnosis be a disc episode. Anti-inflammatories can take days (some up to 7 days) to leave the body. This could make switching to a preferred different class (steroid vs non-steroidals) risky business with days of washout or trying to reduce danger with double stomach protectors.
--- Having meds on board, doesn't give the vet a real opportunity to observe signs and come up with a diagnosis. There are other diseases, too, which can mimic the signs of a disc episode.
--- If there is a suspicion of a disc episode, pain meds stay in the body for about 8 hrs. Pain meds, then, can have last dose 8 hrs prior to the time of the vet visit for the vet be able to observe all signs himself. Anti-inflammatory drugs (steroids or non-steroids) stay days in the body.
-- Prednisone is a hormone drug that needs to be tapered as a signal for the body to begin production of its own steroid hormone cortisol.
Thank you for the information of Pred pill size is 5mgs and 1/2 pill is a 2.5mgs dose. We are very eagle eyed in looking for the position of where the dot is with number of mgs! 25mgs would be a VERY large dangerous dose for an 11 lbs dog.
Fingers crossed that if this is a disc episode diagnosis, with proper meds on board and good STRICT rest principal employed there will not be a reason for a neuro appt on the 20th.
Looking forward to the new family vet's diagnosis and prescriptions tomorrow.
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Post by Diane & Bugs on Dec 28, 2020 15:39:35 GMT -7
Yes it is 2.5 mg Pred. a typo. Well I hope the new highly recommended vet will be able to diagnose him with all the history she will get and his current demeanor. I started the pred as there was no way to get into his vet and I jumped the gun to stop the inflammation. I understand what you are saying. I agree with you. I will keep you posted. iN the meantime he is resting comfortably. Thank you Paula.
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