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Post by Lynn & Chewie on Jan 7, 2021 21:02:40 GMT -7
[Please do not edit this post. Moderator has read and marked post to organize the chain of events and the date each happened on. Please add missing data in a new post in this same thread. Thanks! ] ☆ 1pain? YES, in the morning 1x and 1 x in the evening. Sleeps through the night without waking. YES, moves very slowly and shifts positions side to side when sleeping.☐ shivering, trembling (1 time in the morning and 1 time during the evening)☐ YES, his stomach is tense in the morning 1 x and 1 x during the evening. Neck is squished together when stomach is tense (almost seems like gassy stomach pain) I am uncertain if Gabapentin causing stomach pain or stomach tense - Could this be a side effect? ☐ YES, arched back when in pain and nose to the ground and stays in one positions (very straight) for hours in the morning. His neck is so tense when this happens. But sometimes he lays on his side all stretched out and looks relax so it's been difficult to tell if he is in pain. ☐ YES, his front legs are not straight, paws are bent and crossed sometime. Neck Pain. Back legs are strong and he can hold himself up when squatting for potty time. ☐YES, not normal at all. Stay in one position most of day, he does rotate when sleeping and hardly moves. We started the muscle relaxer yesterday, Jan 6th and he is standing up more often today after he took a long nap (4 hours) in the afternoon. After he woke, he seems more alert and himself and extremely hungry. ☆ 12-13LBS Tramadol - 1 x a day in the morning for pain 1/2 pill (started Dec 10th) Gabapentin - 2 x a day 25mg started (Dec 4th), Dec 25th 1 x a day Methocarbamol started Jan 6, 3 x a day 500mg 1/4 pill for 2 days, taper off to 2 x a day, and 1 time a day Sucralfate - 3 x a day started Dec 4th. for ulcers condition - His stool is regular now. Vertidisc 1 capsule started Jan 5th. Proviable Forte 1 capsule daily started Dec 4th- ended Jan 5th. Prednisone - Dec 3rd (1x a day 5mg), taper off Dec 20th 1/2 5mg 1 x day) B.. 🔘 Dec 3rd 1 (5mg a 1 x a day) to Dec20th, Date of steroid taper? Dec 21st 1/2 5mg 1 x a day. C.. PEPCID AC NO, we have not taken this drug. He is currently on Sucralfate, does this help as well? (NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. www.1800petmeds.com/Famotidine-prod11171.html ) thumb.ibb.co/mEGRuy/91x_Aj_s00z_L_SY355.jpg [Moderator's Note. Please do not edit 12-13 lbs /5.9 kg Prednisone as of 12/3: taper dose of 5mgs 1x/day , 12/20 2.5mgs 1x/day Tramadol - 25mgs 1x/day Gabapentin 25mgs 1x/day Methocarbamol as of 1/6: 25mgs 2x/day for 2 days Sucralfate ? mgs 3x/day ]☆ 3 -- Eating? YES. NO vomit or Nausea -- Stool is normal as of Dec 22nd ☆ 4 What breed? Y orkshire Terrier What is your dog’s name? Chewie Your name, too? Lynn Wong☆ 5 diagnosis of IVDD?, YES but without MRI or Xrays. -- YES, General DVM☆ 6 What was the date you saw the vet for CONSERVATIVE treatment? Dec4th. ConservativeSuper 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 dragging or meandering at potty times. - no PT - no chiro therapy Why Chiropractic is not recommended for pain for an IVDD dog: dodgerslist.com/2020/04/22/chiropractic/☆ 7 YES he can sniff and squat. Bladder and bowel are normal now. DOGs with BLADDER CONTROL: 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 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!
☆ 8 wobbly walk? YES when going to Potty and stands with mainly 3 legs ( front right leg seems to bend more than others) YES, but doesn't wag as much as before.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Jan 7, 2021 21:38:25 GMT -7
Lynn, welcome to the Forum. I'm getting to the point right away because your dog has never been Rx'd the anti-inflammatory level of prednisone. Your vet started with the taper level 5mgs pred 1x/day. Taper levels of pred do not work on getting the very painful spinal cord swelling down. Is there perhaps a health reason why your vet is being so cautious in use of even the pain meds? Liver, Kidney or some other disease? Pain meds for IVDD last in the body only for about 8 hrs. So with Rx's of every 24hr (tramadol) or every 12 hrs (gabapentin) this explains why twice a day your dog is in such pain. Neck discs just ARE more painful and need an aggressive use of pain meds AND the anti-inflammatory level of prednisone. -- Which front leg (r or l) does your dog hold up, not want to bear weight on ?-- Which legs (front or back) are wobbly?-- Have you done 100% very STRICT rest inside of a recovery suite since being diagnose on 12/4? Carried to and from the potty place with very, very limited footsteps allowed to take care of business?-- Had your dog been on a different anti-inflammatory (a NSAID or other kind of steroid) prior to 12/4? Name? Last date dosed? -- How many mgs of sucralfate at 3x/day? What part of a full 1gram tab do you give? ADVOCATE first thing in a.m. tomorrow unless there is some sort of health reason to explain such low use of IVDD meds. -- Prednisone at the anti-inflammatory level: 5mgs 2x/day. Most vets will guess at a 7-day or a 14-day course then begins a taper to 5mgs 1x/day and so forth. I may take 7-30 days before all painful swelling is gone. NO TAPER DAYS work on swelling. It may take several pred course to add up to that 7-30 range before spinal cord inflammation is gone. Excellent reading about use of anti-inflammtories during a disc epidode.--- dodgerslist.com/in-the-right-place/ dodgerslist.com/2020/04/18/steroids-vs-nsaids/
-- Tramadol a full 50 mgs tag promptly every 8 hrs. -- gabapentin could move up in mgs to higher than 25mgs. Definitely an Rx for promptly given every 8 hrs.-- Methocarbamol is Rx's properly at 125mgs 3x/day! Yeah!-- PEPCID AC (famotidine) Dogs don't speak up at first signs of stomach damage like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. Pepcid AC (famotidine) blocks the production of acid. Sucralfate bandaids over damage stomach lining areas. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours. www.1800petmeds.com/Famotidine-prod11171.html 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). Excellent reading about use of anti-inflammtories during a disc epidode: dodgerslist.com/2020/04/18/steroids-vs-nsaids/
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jan 7, 2021 21:42:35 GMT -7
There are extra things you can do at home to help the neck disc heal, such as softening hard kibble, raising food/water dishes, etc. More info here: dodgerslist.com/2020/05/05/cervical-care-tips/EMAIL ALERTS Please enable receiving email alerts when someone has posted. Timely interaction/communications is needed when helping your dog. How to set up: dodgerslist.boards.net/thread/7353/register-bookmark-dogs-post-thread
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Post by Lynn & Chewie on Jan 8, 2021 0:33:50 GMT -7
[Please do not edit this post. Moderator has read and marked post to organize the chain of events and the date each happened on. Please add missing data in a new post in this same thread. Thanks! ]
Hi Paula, Thank you for speedy response and taking your time to review my situation. It's been an emotional roller coaster since the entire ordeal. See response below.
Timeline: (Just my notes) Not the best. Dec 4th - F(Medication: Amantadine 12hrs, Gabatin every 8 hrs), Entyce, Sucraphate, Flagyl, and Proviable, Prednisolone - 5mg 1 tablet. Dec 8th - Stood up all 4 legs and was able to walk slowly. All medication is working and Prednisolone seems to be working. Dec 9th-Dec14 - Doing really well, slightly walking, all 4 legs works. Dec 15th - Diarrhea returned since ulcer and stomach medication was completed. Dec 15th 11pm -[RELAPSED DISC] Snorted and Sneeze, Yelp out in pain - all 4 legs stop working again. =( Dec 16th - Started him back on Sucralfate, Flagyl, and Proviable. Ate a little of the BIOME, just a small handful. Dec 18th - Poo was better/50% Wet like Tar. He won't eat the BIOME as recommended, we tried everything to entice him but no luck. Dec 19th - Back legs are working. Poo is better. Dec 21st - Back legs and Left front leg is working. Front right leg does not work at all and wont flip back. [Taper] Started 1/2 a Prednisone as instructed - Taper off day. Dec 22nd - Urinating well and Poo looks good. Appetite is approving. Dec 23rd -24th Same Dec 25th - Slept through the night without taking PM pain medication. Dec 26- Dec 28th - Only took 1/2 Tramadol at 5am - Slept through the night., Dec 29th - 30 Same (Eating about 1 bowl of food per day - spread out 3 x a day) Dec 31st - Doctor wanted him to skip one day of Prednisone every other day. Pain return immediatetly Same day. Jan 1st. Doctor says to stop tapering Pred. Same Morning Pain and Evening Pain. Taking Tramadol 1/2 in the AM, and 2X a day with Gaba. Jan 2nd to 5th - Same Morning pain, and 7pm Pain. Eating, drinking, and potty is good. Jan 6th - muscle relaxer Methocarb started dose at night time. Slept well. Jan 7th 2nd dose of muscle relaxer, he is more alert after deep sleep (4 hours). Stood up more, tried to walk. Front legs are still wobbly. Front right leg [F.R paw knuckles] is still not flipping back. More appetite today. Ate 2.5 bowls of food.
[Moderator's Note. Please do not edit 12-13 lbs Carporvet by family DVM. as of 11/24: 25mg 2 x a day last dose on 11/29 no 5-7 day washout before ER Rx'd Pred. No double GI protectors: pepcid AC + sucralfate! 11/30 GI tract damage, neuro loss, due to no Pepcid AC on board!!! 12/16 STRICT rest started 12/8 stood on all 4 legs, able to walk 12/15 diarrhea returned due to sucralfate stopping and no Pepcid AC on board. 12/15 RELAPSED DISC all 4 legs paralyzed, related to sneeze and yelp Prednisolone ER Rx'd. as of12/15 relapse: taper dose: 5mgs 1x/day , 12/21 increase taper 2.5mgs 1x/day, then EOD dose √12/31 pain as of 1/1: ▲5mgs 1x/day Amantadine 12/4: 1 ml 2x/day STOPPED Tramadol - ▲50mgs ▲3x/day Gabapentin 25mgs ▲3x/day Methocarbamol as of 1/6: 125mgs ▼2x/day ✙ Pepcid AC 5mgs 2x/day Sucralfate as of 12/4: ? mgs 3x/day pink pill that we have cut to 1/4]
Yes, our current vet only prescribed 1 x a day 5mg and then now 1/2 per day. They are not big believer on Prednisone. They wanted to taper him off to start him on NSAID drugs once off of prednisone. I did bring this up from the start when he was on Prednisone 5mg full pill, he would stand up and seems to more himself. The prednisone was working very well until we tapered. I did try to advocate this but our vet said Prednisone is not their preferred drug as it cause organ failures if used for a long time. I am uncertain why the low Rx.
His bloodwork came back very good. No history of kidney or other diseases. He was full of life and energy. We had no medical issue with him until now.
He did get an ulcer from the start, when he started all the pain medication, full doses every 8 hours of gabapentin, Amantadine 1 ml at nighttime starting Dec 4th. He was still having morning pain. Therefore the Vet added Tramadol every 12 hours. Perhaps the swelling hasn't gone down from low dosage Prednisone as you mentioned.
We went to ER on 11/30/20 and thats when they prescribed just 1 pill 5mg Prednisone 1X a day. The ER told us to start him on 12/3 (3 days after using the NSAID Carprovet).
Our current Vet said we can taper off his pain meds if we feel he didn't need it. It's mainly because he was having runny stool and bloody stool. The vet thought it could be a contributor as did I. Another reason for the tapering off of pain meds was that he finally slept through the night so we thought his pain has gone down and that is why he is not getting his full 3 x a day for Gabapentin and Tramadol. Tramadol doesn't seem to work anymore. I would give him Tramadol at 6:30 am and his pain will be there at 7:30am or 8am. Therefore, I thought his pain stems from his stomach as he was suffering from an ulcer at the very beginning. He was not on Pepcid in the beginning that is why he developed an ulcer (bloody stool) from all his medication. I learned that now.
I will start putting him back on full dosage [▲tramadol, ▲gabapentin].
-- not want to bear weight on? Front R leg. -- 2 front legs are wobbly. He can stand, but the right front leg is definitely weaker (paws bend and would fall). -- Have you done 100% very STRICT rest inside of a recovery suite since being diagnose on 12/4? Carried to and from the potty place with very, very limited footsteps allowed to take care of business? We started doing [STRICT rest] on 12/16 when he had his flare up again on 12/15. -- He was only on Anti-inflammatory when he acted strange with curve back and took him to a vet on 11/24 and they prescribed Gabapentin 1 ml 2 x a day, Carprovet 25mg 2 x a day, and Methocarbamal 1ml 2 x a day. He was still walking very wobbly at this point but we thought it was the drugs as the doctor told us it was very drowsy. We ended up at the emergency for diaherea and 1 vomit, and not urinating, and loss the use of his limbs on 11/30 (6 days later). Therefore we stop Carpovet on 11/29.
-- The bottle doesn't show the mgs so that is why I couldn't give you mgs answer. [Sucralfate] full pink pill that we have cut to 1/4 of a pill 3 x a day.
ADVOCATE first thing in a.m. I will try my best. I will review these links. Thank you.
-- ▲Tramadol a full 50 mgs tag promptly every 8 hrs. - I will start this, only concern will be his ulcer returning. -- gabapentin could move up in mgs to higher than 25mgs. Definitely an Rx for promptly given every 8 hrs. -- Methocarbamol is Rx'd properly at 125mgs 3x/day! Yeah! Vet only want him on this for 7 days. He has to taper ▼methocarbamol off this on the 3rd day to 2x a day. We just started this yesterday Jan 6. He is on his 3rd dosage and it seems be working very well. Makes him sleepy but he wakes up very alert and stood up more often, and his appetite came back. He acted more like himself after 2 dosage so far. -- ✙ PEPCID AC (famotidine) - I will start him on this ASAP.
Thank you so much!!!!. We obviously have been administering his pain meds incorrectly. I will keep you posted on his progress.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Jan 8, 2021 11:25:48 GMT -7
Lynn, the preferable way to communicate with us IS the orderly timeline. Your ordering with dates saves us much time in learning the essential points about your dog. THANK YOU SO MUCH for putting events in order with dates in that time line! I never could figure out why things seemed to be off, but now it it makes complete sense having you give the full history of meds and what happened. I'm so sorry there has been a nightmare of vets (ER and family vet) not having a full command of IVDD and the very unfortunate dragging out of treatment time, pain for Chewie. Simply put not every vet can know every single disease known to all the species they treat (farm animals, cats, all the various breeds of dogs, hamsters, birds, etc.) But you certainly can know A LOT about just one disease in order to monitor things, discuss things and when dangerous but well intentioned advise is given to politely reject it. As time permits, do go over to our main website to absorb all you can. Plant seeds in your mind to ring door bells you've read something about "that" and to be able to go back and re-refresh your memory. Dodgerslist main treasure trove of info is located on www.dodgerslist.com just type in a topic in the orange search bar at the top.
How old is Chewie?Quick points on what you need to know about meds-- Dog does NOT go to pred taper levels when there is pain or increased neuro diminishment. Big time "PERIOD on that! -- After an actual anti-inflammatory level course of pred (5mgs 2x/day) for 13 lbs dog, THEN the taper starts. Most vets try short anti-inflammatory courses of maybe 7 or a 14-day course. It is all guess work. It is the pred test taper that tells a vet and YOU if all pain is gone or not. -- If on pred taper pain surfaces or neuro diminishes, that signals the need to get back up on the anti-inflammatory level of pred (another 5-7 day course or maybe a 14-day course). THEN another pred test taper for pain/neuro -- A setback to a healing disc due to too much movement is cause to start at square one with use of pred, recount of 8 weeks of healing rest for the disc. On 12/15 Chewie had about or snorting and sneeze with NEW pain, NEW/INCREASED neuro diminishment. His disc was re-damaged on 12/15. -- When pain surfaces or neuro diminishment increases while in a pred taper test for pain and neuro, that is not a relapse, but indication all swelling had not yet been resolved by pred. It can take a range of 7-30 days with several anti-inflammatory level courses before pred fully rids the body of pain. Taper days (nearing replacement amounts the body makes on its own) do not work on spinal cord swelling. The body makes its own steroid hormone, cortisol, at a much lower level than the necessary higher anti-inflammatory level of pred that works on spinal cord inflammation. The pred taper test is a necessity to signal the body to start making its own cortisol steroid. AND the taper is the PERFECT window to assess how pred it doing with resolving inflammation in the cord. -- Pain meds stay on board and are NOT stopped nor reduced til time for the pred test for pain taper. -- Prednisone will not bring restore neuro damage. The body self heals nerves all on its own. Pred's only job is to get swelling down as fast as possible. Hence the use of the anti-inflammatory level with vets who know their IVDD. With a good bloodwork report, that means the organs are healthy use a rather short term use of pred of about 7- 30 days in getting swelling down. -- Chewie should not be punished for the lack of knowledge in Rxing treatments: 1) Lack of Pepcid AC at initial use of ANY anti-inflammatory (NSAIDs or steroids) to suppress acid production in the stomach. Stomach acids are a primary cause of ulcers! Other causes of acid production are from stress of change in routine/pain. And spinal cord damage which can inhibit the autonomic function that normally protects the stomach lining. 2) Lack of use of TWO (2) GI protectors (sucralfate + Pepcid AC) when doing less than a 5-7 days washout with a switch from Carporvet to steroid. 3) Lack of using anti-inflammatory dose of prednisone to expedite resolution of spinal cord swelling 4) Lack of making it perfectly clear the necessity for 100% STRICT rest with any suspicion of a disc episode. AND very certainly when on Rx med that make a dog feel good and encourage too much movement of vertebrae when then press on bad disc. Please do your very best to advocate for giving it a try to use the typical treatment of anti-inflammatory level pred for maybe 7-day course, then taper. -- Getting ALL 3 pain meds and keeping them on board until the pred test taper day begins. When all 3 meds are on board, they each are working on a different sources of pain. Surely the vet can not actually believe it is ok to not attend to one source of pain by reducing and stopping methocarbamol??? Neck discs typically involve with muscle contraction pain. Also very often with neck discs there can also be root signature pain at the point the nerve root branches off from the spinal cord going to a limb. The Veterinary Specialists of Rochester: In some dogs, the internal degeneration of the disc itself might stimulate sensory nerves and be perceived as a painful stimulus. This is called “discogenic” pain. However, when dogs with neck pain are carefully evaluated, fewer than 5% are found to have discogenic pain as the cause. The other 95% or more are found to have pain due to the actual displacement of disc material from the space between the vertebral bodies into the space above, called the vertebral canal. The vertebral canal is the tunnel which contains the spinal cord and the nerve roots which leave the spinal cord and extend out to connect to the body. Thus, when the disc is displaced it can put pressure on the nerve roots. This is exactly analogous to the problem people suffer with “pinched nerves”. The reason some dogs will hold their arm or leg up is that, as the nerve root which supplies the limb is “pinched”, the brain is fooled into thinking it’s the end of the nerve that is being irritated; the animal probably perceives this as a tingling, numbness or “pins and needles” sensation in its digits. vetspecialistsofrochester.com/pdf/UnderstandingIntervertebralDiscDiseaseInDogs.pdf#zoom=100Does Chewie stand flamingo like on front right limb?, indicating "root signature" pain? This is nerve damage where the dog can't or is slow to right the paw. This dog is knuckling under the paw (nerve damage). Let us know what Chewie is doing with his front right paw.
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Post by Lynn & Chewie on Jan 8, 2021 13:31:57 GMT -7
Hi Paula,
Yes, thank you for your feedback. It's amazing how you understood everything I had written. =)
Just to clarify, do your recommend me starting completely over with his Prednisone. He's currently only doing 1/2 a 25mg now. Should I start him right away on 5mg 2 x a day for 7 days? Please confirm. ( I am sending my current Vet a email and probably won't hear back until next week) I have 20 pills currently.
And to confirm on the Pain medication: Tramadol 50mg 3 x a day ? Gaba 25mg 3 x day? Can I give this to him at the same time as Tram? Methocarbol - started on 1/6 - 3 x day 2 days, then 2 times a day for 2 days
And to confirm the stomach GI medication: Peptic AC - 5mg 2 x a day Sucraphate - 1/4 pill 3 x day
Today, when starting his Gaba 1 25mg at 11:30am, 15 min later he is in his pain stage, tense stomach, straight position, paws under his chin, slightly trembling. He also tries to sit up but falls backward possible due to pain on his neck. Do you think the Gaba would cause such a reaction as the jitters? Perhaps it's his pain episode. I just can't figure this out. This is just a FYI and all guessing.
To answer your questions: Chewie is 8 years old, turning 9 in May. He does do Flamingo style on Front Right paw when he goes to potty. He knuckles when standing. But majority of the time, he is knuckling front right paw.
Again, Thank you and looking forward to your quick response.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Jan 8, 2021 13:58:44 GMT -7
Pred is one med owners should definitely NOT be self prescribing. So get on the phone so you get an answer TODAY about the vet prescribing another course of Pred: -- An anti-inflammatory level course of prednisone 5mgs 2x/day for 7 days, then a taper. Some vets will want to Rx a 14-day course.
All pain meds should be 3x/day. less than every 8 hrs pain can arise as med levels lower. Keep the med level up with every 8 hrs doses.
Typically to fully control pain 3 pain meds are on board: tramadol, gabapentin and methocarbamol. They can all be given at the same time. Makes for an easier schedule for you.
PEPCID AC (one active ingredient of famotidine) 5mgs 2x/day
SUCRALFATE 1/4 of 1 gram (1000mgs) tablet is 250 grams. If your tablet is not a 1 gram tablet, then we do not know what dose you give Chewie. ASK your vet what mg or gram size WHOLE sucralfate tablet being used for Chewie. IT is your right, your duty to know all about each med you give Chewie. Should have been printed on bottle.
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Post by Lynn & Chewie on Jan 8, 2021 15:13:32 GMT -7
Thank you for the confirmation. This is very helpful. I emailed the Vet and left a message. I hoping to hear back.
Another issue that I notice is when he barks, he would be in slight pain =(. He doesn't bark as much anymore. Some will think it's a blessing but it's so sad for me.
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Post by Romy & Frankie on Jan 8, 2021 15:47:42 GMT -7
I think barking could sometimes cause pain when a neck disc is involved. Once the meds are adjusted he may be back to his regular barking.
Please let us know what the vet says when he gets back to 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 Jan 8, 2021 23:47:06 GMT -7
Moved to the forum on behalf of Lynn:
What are you thoughts on supplements? Have you heard of Vetri Disc? I heard many good things about it. I wanted to know if it's a good idea to add it to his meds intake.
Also, since he isn't moving so much, how much food do you recommend feeding him? I have doing 2.5 bowls "Cesar" soft food daily. Is that too much since he is not mobile. Or do you feel he needs to eat less?
Do you think he needs to do No. 2 daily or every other day is sufficient? He's doing daily now but if we cut down his food intake, he might not go daily?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jan 9, 2021 9:25:58 GMT -7
Lynn, I invite you to take advantage of the substantial treasure trove of IVDD information on our main website www.dodgerslist.com There you can use the orange search bar at the top of every page to seek info on many topics of interest to you. SUPPLEMENTS I have not used any joint supplements for my dogs. I recommend as the article about "supplements" on our main website points out you will need to do some self education about the various ingredients that can be in joint supplements so you have the ability to evaluate which product you may like to try out. And while on big gun IVDD meds as explained, it is not the time to add supplements. FOOD Now is not the time to start a diet while on big gun IVDD meds. The reason is nutrition is never more important than during healing. The body actually needs additional protein and nutrients because the body is calling upon its reserves to fuel all the many repair jobs that have to be performed so that healing can take place. Now is no time to be restricting and denying the body that badly needed nutrition by reducing portions just because because of inactivity. Cut out commercial hi-cal treats and sub for low cal small pieces of apple, carrot or frozen green beans, frozen broth cube to lick on. Found this article on Dodgers main website (used orange search bar with "diet") so you will have the knowledge and tools when off all meds and proof of no pain to evaluate Chewie's food: dodgerslist.com/2020/05/22/diet-nutrition/ POOP The longer food stays in the intestines the more moisture is absorbed. That can mean constipation. A daily or more poop is generally good to keep the poop normal. Taking sucralfate can often have the side effect of more firm poops. Monitor poops and take action you see they are getting too hard. Plain pureed canned pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. NOTE: alternatives are really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potatoe) -- To loosen the stool, add equal parts water to each kibble meal and soak overnight. At mealtime add one teaspoon of plain canned pureed pumpkin 1x a day. -- To firm up the stool add 1 teaspoon plain canned pureed pumpkin 1x a day to kibble. Hope you follow up you email with your vet before they close today (Saturday 1/9) about the need for an anti-inflammatory level course Pred in light of pain still existing. Pain evidenced by not barking much anymore, shivering nearing next dose of pain meds, tense tummy, reluctant to move much.
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Post by Lynn & Chewie on Jan 11, 2021 15:35:41 GMT -7
Thank you so much Paula for your response,
I do have a response from my vet. They said he was only 9lbs and now 10 12oz as of Saturday.
I will make sure he does eat well regularly and we are not starving him. He was so hungry one night and we kept giving him food, he ended up throwing up all the food we gave him so that gave us a scare but he has since visited the Vet on 1/9/21 and they are not overly concern. He started getting wet stool again as of 1/9/21. It's not watery at all.
He does have yellow soft stool as of today 1/11/21. So hard stool is definitely not an issue now. I think now I need to find something to prevent him from having watery stool. Let me know if you have any recommendation. His stomach as always been sensitive to everything. Sucralfate and Proviable was very helpful at the beginning I believe. It's been difficult to monitor.
Vet only approved the following meds changes for him.
5 more days of Prednisone 5mg (1/2 2x a day) ▼tramadol is only 1/2 50mg Twice a day max Prednisone as of 1/10: 2.5 mgs 2x/day for 5 days. test taper on 1/16? YES. Vet said he 10lb 12oz, the max Prednisone my vet would agree upon is 5 more days of 2.5mg 2 x day and then taper off.
Pepcid AC - 1/4 2x a day 10 mg Gabapentin every 8-12hours [which?] Methocarbamol stopped tomorrow. 1/12/21.
[Moderator's Note. Please do not edit ▼10lbs 12oz Carporvet by family DVM. as of 11/24: 25mg 2 x a day last dose on 11/29 no 5-7 day washout before ER Rx'd Pred. No double GI protectors: pepcid AC + sucralfate! 11/30 GI tract damage, neuro loss, due to no Pepcid AC on board!!! 12/16 STRICT rest started 12/8 stood on all 4 legs, able to walk 12/15 diarrhea returned due to sucralfate stopping and no Pepcid AC on board. 12/15 RELAPSED DISC all 4 legs paralyzed, related to sneeze and yelp Prednisolone ER Rx'd. as of12/15 relapse: taper dose: 5mgs 1x/day , 12/21 increase taper 2.5mgs 1x/day, then EOD dose √12/31 pain as of 1/1: 2.5 mgs 2x/day for 5 days. test taper on 1/16 Tramadol - ▼25mgs ▼2x/day Gabapentin 25mgs 3x/day Methocarbamol as of 1/6: 125mgs 2x/day; stops on 1/12/21 ✙Pepcid AC 2.5 mgs 2x/day Sucralfate 1gram tab as of 12/4: 250mg 3x/day (pink pill that we have cut to 1/4)]
We started him on 1/2 Pred 2x a day yesterday 1/10/21 Sunday, and he has already shown some improvement. Standing up more and more alert. He wants to walk more now too. He has been crated since 12/16/20. He still sleeps most of the day and stomach is tense 1 x this morning.
He does do a few slight twitches sometime. Do you know if thats part of IVDD symptoms? I have been reading everything on your site as recommended. Thank you so much.
Thank you and we are hopeful 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 Jan 12, 2021 9:08:18 GMT -7
Lynn, sounds as though you might be reporting some positive things. Please do tell us more so we have the correct information: ---- "Standing up more" What do you observe so we can picture exactly as your eyes see things. Does he push his back legs up in to a stand position more often? Or are you observing if you place him in a stand position he can stay up for more time?
---- "He wants to walk more" When supported with a sling, do your eyes observe his back legs making walking motions? OR does he want to walk more on his front legs while the back legs are supported with a sling but do not attempt any walking motions?
---- "slight twitches sometime" Does not give us much to go on. • On what part of the body do you see the twitches? • How many times a day? • What was Chewie doing when your eyes saw the twitching? • How long does twitching last? • What relationship was there with time the next dose methocarbamol (muscle relaxer) had been due? • With methocarbamol now stopped today, 1/12, what do you observe re: twitches.
Which do you actually now give Gabapentin at? Every 8 or 12 hrs? We appreciate to know the vet gave you a range in frequency. The important in formation is, however, what frequency and Mgs Chewie actually is getting.
Interesting and very unusual that the tapering off of pain meds is happening before the pred taper test for pain goes into effect this Sat. 1/16! If pain should appear say on Sunday when your vet is not open, what is the plan B you both have worked out regarding pred, regarding pain meds until you can contact him on Monday?
Please do be watchful for any increased pain surfacing or pain surfacing near the next dose of the remaining pain meds on board (gabapentin and tramadol).
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Post by Lynn & Chewie on Jan 12, 2021 15:47:27 GMT -7
He has always been able to get up to go potty and walk normally (all 4 legs walking normal except he is weaker on the front right paw) He walks gingerly but only walks aggressively when he goes potty. He actually can pull us when he goes potty. Of course we tried out best to prevent him from walking too much.
He can stand for a good 10 minutes so far. He still has his neck spasm regularly though =(. I forgot to mention, on Saturday 9th, he threw up all his food and medicine (40 minutes after taking his medicine) It was Sucra and Tram. We had appointment with the Vet for a checkup and she gave him a Cerena Shot. Vet told me isolate each medicine to see if it's causing him to vomit. After the [1/9] Cerenia Shot, he was more active and alert when got home. I guess the Vet says is has anti-inflamatory formula as well. First time we actually saw some improvement. No vomitting for the rest of day. He had wet poop this day.
1/10/21 Sunday We decided this day to only give him Tram and ✙Methocarbamol for pain so we can isolate Gaba for another day. He had 1 episode of pain - mid level. He ate ok and poop was small still wet. 1st day of 2.5mg Pred. No Vomit. 1/11/21 Poop was yellow and wet. Peptic AC 1/4 2X added to daily medicine. Had 2 pain episode 9am and 7pm. Only Tram and ✙Meth for pain on board today. No Vomit. Ate OK. 1/12/21 Poop was large and wet still. Ate food and sucra, and introduce 1/2 Gaba. In about an hour, he went to a pain position and then vomited. About an hour later, He pooped again and it was diarrhea. My conclusion is Gaba is not for him and causing nausea or stomach pains. Fed him some chicken broth and rice. Gave a Cerenia meds and 30 min later he looks refresh and better.
We will continue to do Tram and introduce ✙Amantadine (which was the other pain meds Vet gave me) tonight so he can sleep well.
[Moderator's Note. Please do not edit 10lbs 12oz Carporvet by family DVM. as of 11/24: 25mg 2 x a day last dose on 11/29 no 5-7 day washout before ER Rx'd Pred. No double GI protectors: pepcid AC + sucralfate! 11/30 GI tract damage, neuro loss, due to no Pepcid AC on board!!! 12/16 STRICT rest started 12/8 stood on all 4 legs, able to walk 12/15 diarrhea returned due to sucralfate stopping and no Pepcid AC on board. 12/15 RELAPSED DISC all 4 legs paralyzed, related to sneeze and yelp Prednisolone ER Rx'd. as of12/15 relapse: taper dose: 5mgs 1x/day , 12/21 increase taper 2.5mgs 1x/day, then EOD dose √12/31 pain as of 1/1: 2.5 mgs 2x/day for 5 days. test taper on 1/16 Tramadol - 25mgs 2x/day Gabapentin 25mgs 3x/day STOPPED 1/12 vomiting ✙Amantadine 12/4: 1 ml 2x/day ✙Methocarbamol as of 1/10: 125mgs 2x/day Pepcid AC 2.5 mgs 2x/day Sucralfate 1gram tab as of 12/4: 250mg 3x/day (pink pill that we have cut to 1/4)]
I hope this clarifies some questions. Thank you again for the support to heal my baby. I will be touch with Vet tomorrow to confirm what Plan B will be.
To confirm: Sucrafate - 1 gram tablet. 3 x a day.
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Post by Romy & Frankie on Jan 12, 2021 16:13:49 GMT -7
I am glad that you are trying hard to prevent Chewie from moving too much. It would be terrible if he were to have a relapse.
Gabapentin may not agree with Chewie. Gabapentin can, in some case, cause vomiting. Was he taking the sucralfate the whole time or did you stop that also while you were isolating the meds? Please speak to the vet about a substitute for Gabapentin. Vets have many ways of treating pain.
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Post by Lynn & Chewie on Jan 18, 2021 13:03:08 GMT -7
Hi Paula,
---- "slight twitches sometime" Does not give us much to go on. • On what part of the body do you see the twitches? • How many times a day? • What was Chewie doing when your eyes saw the twitching? Standing and sitting • How long does twitching last? • What relationship was there with time the next dose methocarbamol (muscle relaxer) had been due? • With methocarbamol now stopped today, 1/12. Answer: Since stopped, his neck twitches has diminished. He twitch less now. Perhaps it was a side effect from Methocarbamol.
From 1/10/21 to 1/15/21, He is standing and sitting more. He is barking more. He was able to flip back his front right paw (big improvement). He was more hunger and thirstier. He has less pain for sure during this period. On 1/15 to 1/17, He started to pant in the evening for about 40 min. Do you know if this is a side effect from Prednisone?
On 1/16 taper day, he took just 1 x 2.5mg and by the end of the day his legs were not working well again. Two front legs were wobbly again. The next morning 1/17 when potting, he was very weak and curled his back. We ended giving him is 2nd 2.5mg at night time based on Vet instructions. Today 1/18 he stood up strong in the AM after a good night sleep and is back to himself. Therefore, he could not taper. Do you have any suggestions as far as what I should do from here?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jan 18, 2021 13:24:30 GMT -7
PANTING: -- Try a fan near crate but not pointed at the dog to help circulate air some. --Try a frozen broth ice cube to lick on. Dr. Isaacs discusses this issue: www.dodgerslist.com/neurocorner2/panting.htmWhen on a pred taper dose, you see either pain and or worsening neuro function, you report it promptly to the vet. Likely another course of pred for 5 or 7 days would be Rx'd. Then another pred taper test would start for another check to see if all painful swelling is gone
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