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Post by Jessica & Roxy on Apr 19, 2021 19:40:13 GMT -7
[This post is being marked. If there are any corrections or updates, please place them in a new post. Thank you!]Please help  We received our diagnosis [4/19] today after my 11 yr old mini dachshund Roxy jumped from the couch [4/17] and landed poorly on Friday and developed symptoms over the weekend.. We are so grateful for the help and insight.. I want to act quickly to prevent further damage.. QUESTIONS ☆ 1 Is there still currently pain? Yes, slow, ginger movements, favoring neck and chest area. Trembling yesterday but not today. Yelping when picked up or moved. Nose held towards ground. A little bit lethargic and down. ☆ 2 11 pounds Rimadyl 1/2 of 25mg tablet twice per dayGabapentin 0.6 ml every 8 to 12 hours Starting today and planning to do 7 AM and 7 PM [Moderator's Note. Please do not edit
11lbs 11 y.o.
crate rest started 4/20
Rimadyl as of 4/17 owner dosed:
as of 4/19 12.5mgs 2x/day Rx'd for ? days, then test stop for _pain/_neuro
gabapentin ?mgs in 1 mL?: ?mgs 0.6mL dose WHICH: every 8 or 12? hrs?
needs GI tract protector, Pepcid AC, on board w/Rimadyl! ]C.. PEPCID AC surpasses the acids Rimadyl causes: I’ve never used Pepcid with my dog - What should I use this for?
☆ 3 -- Very good appetite still and drinking water. No vomiting but had diarrhea on Saturday 4/17/21, the day after she fell funny from the couch. Poops okay Sunday and today. No black or red stool.. ☆ 4 Roxy Miniature Dachshund Jessica ☆ 5 diagnosis of IVDD?, Yes, we are waiting on discharge paperwork but diagnosis for IVDD was today from emergency vet, general DVM ☆ 6 We saw vet today (Monday) after fall on Friday and looking uncomfortable and in pain this weekend.. seemed off Saturday with diarrhea.. Sunday was crying when picked up, trembling, and uncomfortable.. Gave her Rimadyl [4/17] that was on hand and visited vet Monday.. Monday she was much more comfortable but still pain re: vet in neck laterally left to right and in thoracic spine Surgery, MRI were not recommended as she is still walking normally. Recommended crate rest and medications for 2 weeks, follow up with primary vet in one week, and supervision of symptoms.. My dog hates her crate what can I do to help her be comfortable?!? I am worried she will hurt herself more because she scratches to get out of it I purchased an ex pen in hopes this will help her be more comfortable but it won’t be here for another day or two.. Please any advice appreciated!! She is my best friend and I’ll do anything to keep her healthy and comfortable... I also have a Respond Systems laser and PEMF therapy bed for her.. Would this be helpful?? ☆ 7 Yes current bladder control ☆ 8 Yes she is still walking and wags her tail.. the vet told is her case is mild but that she’ll have this for the rest of her life and I want to know how to manage it so it gets better and not worse
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Apr 19, 2021 20:42:00 GMT -7
Jessica, welcome to the Forum. Thank you for answering the questions, really helps us! There is a pain emergency to get the meds corrected for Roxy. Phone the ER clinic tonight where any vet there now on duty can adjust the pain meds because they have access to Roxy's file. With your description, sounds as though this is a NECK disc problem. They are more painful and typically will need three (3) pain meds each working on a different kind of pain. Pain meds last about 8 hrs in the body. This is why Roxy is suffering with pain....need an Rx from the ER vet tonight to give promptly every 8 hrs.
Resolution of spinal cord inflammation/swelling provides the relief from pain. It can take the anti-inflammatory Rimadyl a range of 7 to 30 days before all swelling is gone. IN the mean time proper pain meds NEED to be on board. Pain meds when correct work in one (1) hour!
--Advocate for: — 1) Methocarbamol works on the pain of muscle spasms common with a disc episode. — 2) Tramadol is the general pain reliever. — 3) Gabapentin works on nerve pain. Were you giving gabapentin 2x/day? If YES, then give 3x/day! -- 4) Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. famotidine suppresses the acids stress and Rimadyl cause. Roxy doesn't need another problem of bleeding ulcers on top of this disc episode.
Know all meds as a safety factor. Best place for looking them up at the Mar Vista Vet med directory: www.marvistavet.com/pharmacy-center.pmlNow you and the vet know Roxy was born with disc disease. Some dogs have only one episode while other can have multiples. It takes eight (8) weeks for the disc to heal by providing STRICT rest in a recovery suite. CALMING STRATEGIES Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives (ACE, alprazolam or trazodone). You may need to start one of the Rx sedatives if Roxy is too active then see if you can transition to callers below. Of course always keep your vet in the loop on all things you give your dog. Place a DAP pheromone diffusor at floor level where the recovery suite is: --DOG Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/Use diffusor with one oral calmer from below:Oral calmers: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. www.vetriscience.com/composure-soft-dogs-MD-LD.php EMERGENCY CRATE TRAINING dodgerslist.com/2020/02/24/tips-to-help-with-recovery-suite/UNWANTED BEHAVIOR 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. TIPS TO HELP WITH BEHAVIOR ISSUES: -- Many members have found a pet stroller to solve the whining problem because the stroller can be wheeled from room to room as you go about your activities. Pet strollers, however, should only be used when you are directly supervising. More details on strollers: dodgerslist.com/2020/05/17/pet-stroller-conservatve-treatment/-- Put a garment you have been wearing and have not washed in the crate. -- At night, try placing the crate on a sturdy bedside table to sleep next to you. This way you can touch through the wires. -- During the day try the coffee table or the dinning room table so there will be a view out a window and a better perspective on what is going on in the house from a high. -- Make the crate or ex-pen more cozy by draping a blanket over part of the top.  ** Let us know the date you started true conservative treatment of VERY STRICT rest. STRICT means:- no laps - no couches- no baths - no sleeping with you- no meandering at potty times.- no PT - no chiro therapy
- eats/drinks in the recovery suite - Carried to and from the potty place, then very limited footstep to take care of business Why Chiropractic is not recommended for pain for an IVDD dog: dodgerslist.com/2020/04/22/chiropractic/For how many days is the Rimadyl Rx?
Look forward to hearing what the ER vet Rx'd to help with pain and the answers to questions so we know more how to help. |
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Post by Jessica & Roxy on Apr 20, 2021 18:56:32 GMT -7
Thank you so much for all of your suggestions! We are working on everything now! Crate rest began [4/20] today although she’s not loving it but we are trying all of the suggestions below to make her more comfortable..
I have a call in to the vet on her medications and we will start 3x a day versus two with the ▲Gabapentin - We have liquid form.
[Moderator's Note. Please do not edit
11lbs 11 y.o.
crate rest started 4/20
Rimadyl as of 4/17 owner dosed
as of 4/19 12.5mgs 2x/day Rx'd for ? days, then test stop for _pain/_neuro
gabapentin ?mgs in 1 mL?: ?mgs (0.6mL dose) ▲3xday
needs GI tract protector, Pepcid AC, on board w/Rimadyl! ]
Is there any suggestions for hiding the taste of it? We’ve been giving it via a little syringe by mouth but she just hates the taste of [gabapentin] it and we don’t want to struggle with her because we are trying to limit movement.. Any suggestions appreciated! For the other medications, how long is typical to keep them on the meds? I just want to make sure I’m informed when I speak with the vet!
I am not sure how long she is supposed to be on the Rimadyl - We need to follow up with her vet on this as well!
We have an appointment with our primary vet on [4/23] Friday - I’m wondering if we should look into establishing care with an IVDD specialist? Or should we focus on stabilization first?
She has been mostly comfortable/sleeping today.. We did have one cry when we brought her out to go potty.. She was anxious to get down and was put down softly but still whimpered 😢 Is this something to be expected or an indication that something is off in her care? Are we reinjuring her when we put her down and she does this? We’re trying our very best— Thank you for all your help and suggestions!
Thank you thank you thank you!!!
- Jessica and Roxy
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Apr 20, 2021 21:23:01 GMT -7
Jessica, good job on upping gabapentin to 3x/day. And getting Roxy into a recovery suite to aid in disc healing and prevention of nerve damage. The most important thing is to make sure all pain is controlled by pain meds. "Mostly comfortable" is not good enough. If there are signs of pain when moving her, lifting her or setting her down, etc. then assume what is well known — neck discs are typically quite a painful thing. So this is where we stand on this Forum about pain...we side with Dr. Downing. Robin Downing, DVM, CVA, DAAPM is one of only four veterinarians in the world to hold the Diplomate credential in the American Academy of Pain Management - the largest interdisciplinary pain management organization in human medicine: "It is always better to use a multi-modal approach to pain management." And we side with the World Small Animal Veterinary Association (WSAVA) guidelines as well: Waiting til a Fri 4/23 appointment is too long to wait for a dog in pain. There is no reason the ER place where she was examined and where there is a file on Roxy, the ER vet on duty can't prescribe full pain relief tonight. --- What did ER say when you advocated for Methocarbamol (works on the pain of muscle spasms common with a disc episode) and Tramadol (the general pain reliever.)? Why were meds not Rx'd for Roxy today?--- When will you have Pepcid AC (famtodine) on board to suppress the acids Rimadyl causes? While not all vets may appreciate the need for acid suppression, you can be in the know why Pepcid AC is so important when on Rimadyl: dodgerslist.com/2020/05/06/stomach-protection/SPECIALIST CONSULT With a dog who has pain only, the reason to see a consult with a specialist is if your family vet or the ER vet lack confidence to prescribe proper pain medication for full control of pain. Specialist use pain meds every day to help to get pain full in control similarly to the meds pointed out to you. Good idea to have a sense of conservative treatment vs. surgery under your belt. Good reading here: dodgerslist.com/2020/02/10/surgery-vs-conservative/Describe what you observed that made you write "mostly comfortable"Specific descriptions help us to understand things best. What time of the day did you observe? GABAPENTIN IMPORTANT: Would you look on the gabapentin bottle for the formula. How many mgs of gabapentin are in one mL of liquid?Place the tip of the syringe in the mouth, just behind one of the canine teeth. Angle the syringe slightly to the side and deposit the medications onto the tongue. Gently stroke under her chin to encourage swallowing. Follow up quickly with a tiny but very yummy treat (cream cheese ball, liverwurst ball, no-fat meat) to encourage swallowing and as a reward PLUS to take away the taste.  ROADMAP for your fridge Avoid dangerous detours. VIEW, DOWNLOAD and print: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdfMEDS used with a disc episode. -- Anti-inflammatory is used until all painful swelling is fully gone -- Pain medications are used until anti-inflammatory resolves all the pain -- Be fully informed on all the details of meds used during a disc episode to help you best discuss things with your vet: dodgerslist.com/2020/04/22/healing-swelling/-- Extra things you can do at home to help with a neck disc. Won't hurt even if this a back disc: There are extra things you can do at home to help the neck heal, such as softening hard kibble, raising food/water dishes, etc. More info here: dodgerslist.com/2020/05/05/cervical-care-tips/It really warms our hearts to hear some of the tips and ideas we give, are of help to you and your sweet Roxy. Thank you for acting fast to implement them! |
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Post by Jessica & Roxy on Apr 28, 2021 17:34:22 GMT -7
Thank you so much for all your expertise and advice.. We are so grateful for your guidance.. Since we last updated we were able to get her pain meds adjusted. We’ve been able to start all three pain medications, and we added the Pepcid AC after your last response so she’s now been on that for a while.. Her follow up appointment on 4/23 went well.. No visible soreness on palpation. At that time her vet prescribed her prednisone instead of the rimadyl. There was a transition period [last date of Rimdyl?] where we switched the meds now to prednisone. She’s now getting 5 MG 2x / day for 5 days, then 5 MG / day for 5 days, and then 5 MG once every two days for 5 days and going from there. The reasoning behind our vet’s switch to prednisone was that she felt it was more effective in treating inflammation than the rimadyl, would be quicker acting, and could promote healing more quickly to keep her comfortable. [Moderator's Note. Please do not edit
11lbs 11 y.o.
crate rest started 4/20
Rimadyl as of 4/17 owner dosed
as of 4/19 12.5mgs 2x/day STOPPED 4/23
No 5-7 day washout with switch, no doube GI tract protection (pepcid + sucralfate)
prednisone as of 4/25: 5mgs 2x/day for 5 days, 4/30 test taper 4/28 √pain /4/28 √ neuro
as of 4/28: 5 mgs ▲3x/day for 1 day
as of 4/29: 5 mgs▼ 2x/day for ? days
gabapentin 50mgs/mL: less than 30mgs (0.6mL dose 3x/day ran out 4/28
gabapentin 100mg capsule as of afternoon 4/28 : 50mgs 2x/day
methocarbamol 125mg 2x/day
tramadol 12.5mg 2x/day
Pepcid AC 5mg 1x/day ]
She has been super good the past few days- No symptoms of concern, normal poops, looked good when going to go potty for those few [foot?] steps of walking, and then has been relaxed in her crate. We did get the pheromone diffuser and have been staying next to her crate to keep her comfortable. No symptoms all morning - Went potty twice and looked good. Around 5 PM [4/28] I brought her out to go potty and she wobbled, peed, and then was ▲limping significantly and ▲ favoring her right shoulder. That is the same shoulder from the couch fall that started all this We picked her up right away and put her in her crate at that point she she hasn’t walked on it since.. We are very worried.. We spoke with both her primary vet and her emergency vet from before to consult.. Today we were getting a refill of her ▼ Gabapentin so she didn’t receive her full dose today. The vet thinks that the pain may have come through because we were waiting to get her Gabapentin refilled.. Her primary vet also chose to up her ▲ Gabapentin MGs.. Before she was getting the liquid at 0.6 ml 3x / day.. We now have the tablets as the liquid at Walmart pharmacy contained xylitol.. The tablets are 100 mgs.. It is prescribed at 1-3 x / day.. Our vet said to start with 50 mg 2-3 times per day and go from there. Because of the limping tonight she had us give one extra dose of prednisone for 3 total pills today at 5 mg along with the Methocarb/Tram and higher dose of Gabapentin.. Roxy is resting comfortably now in her crate but I am worried especially because she was doing so well so it seemed.. Is this type of incident normal in recovery? What should we watch for going forward? Have we missed something more worrisome on her initial exam? The first vet didn’t think she looked bad enough to MRI because she was walking normally.. I asked about an X-ray and she thought only a MRI would tell us what was going on but that an X-ray likely wouldn’t be helpful.. Is this something that we should do now to get a full assessment? I’m worried we missed something important.. Or is this a typical set back and not a reason to panic? She did not seem painful when I picked her up after the limp.. I’ve been very careful carrying her and haven’t had any pain incidents since the day after her initial diagnosis.. We were told if she exhibits any neurological symptoms, dragging toes, or ataxia to bring to emergency vet.. it is 3 hours away but we will go at any time if she needs it.. they are a 24 hour ER at the University of MN.. Is there anything else I should watch for? Does the increased pain dosage make sense for her? She is 12 lbs. We also plan to update our primary vet tomorrow on how she is tonight.. I think we’ll find out a lot more when we take her out to go bathroom next.. all meds are current now that we were able to get the refills and added the extra prednisone today.. Would you have any different advice from that which we’ve already received? We are also setting an appointment with a neurologist at the U to follow up though they said the waitlist is July unless/until it becomes an emergency.. Should I be concerned that this much pain came through when the pain meds were being refilled? I worry that it may be hiding what’s going on or that I’m missing something.. We want her to be comfortable I just want to make sure I’m not missing anything.. Jessica & Roxy The only pain I observed at first was the crying when picked up. I have not noticed any of that since last post and actually she looked great until today where she didn’t look as comfortable (laying a little guarded) and the wobble and limping when last put outside. No symptoms first two times out outside today. GABAPENTIN How many mgs of gabapentin are in one mL of liquid? 50MG/ML is what she was receiving of the liquid.. We ran out of the liquid and now have 100 mg tablets.. Also in regards to the Conservative v. Surgery article - I want to be sure I know what to look for if she were to need surgery.. How would I know when that emergency arises or when DPS is lost? What would I look for? Thank you so much for all you do!!!! Update! We did a potty break and no limping for the couple of [foot?]steps [not stairs/steps?] she did outside! Resting comfortably now in crate.. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Apr 28, 2021 18:54:07 GMT -7
Would LOVE to be able to comment. However, can not follow the meds you write about. MED DETAILS NEEDED For each med you write about give the ACTUAL dose in mgs, ACTUAL frequency you are currently giving.
Give the date the prednisone 5mgs 2x/day started AND date tapered to 5mgs 1x/day.
Date of last dose of Rimadyl?
----------------------------
IN PINK are the missing med details which paint a picture to allow comments:
crate rest started 4/20
Rimadyl as of 4/17 STOP DATE?
prednisone as of 4/23?: 5mgs 2x/day for 5 days, 4/28 √pain for: /4/28 √ neuro A five-day course of pred is clearly not long enough to get the spinal cord swelling down. Good place to understand the use of anti-inflammatory drugs during a disc episode:
dodgerslist.com/2020/04/18/steroids-vs-nsaids/
gabapentin 50MG/ML: 30mgs (0.6mL dose) 2x/day STOPPED 4/28
gabapentin 100mg capsule: actually given?: 50?mgs 2x/day?
methocarbamol ?mg ?x/day
tramadol ?mg ?x/day
Pepcid AC ?mg ?x/day
----------------------------
IN GENERAL Due to lack of details of the med list, below are general points -- The date pred begins a taper to 5mgs 1x/day, is a test for pain and neuro issues surfacing. So if pred did begin a taper that is the reason for seeing pain surface and worsening neuro issues. This should indicate to the vet to given another course of pred. The 5-day course of pred was not long enough to get all the swelling resolved. -- As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross 3. Nails/toes scuffing floor 4. Paws knuckle under 5. Weak/little leg movement, can't move up into a stand 6. Legs do not work at all (paralysis, dog is down) 7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors. 8. Tail wagging with joy is lost 9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy. Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS. When surgery is a consideration?If your dog can’t walk OR with STRICT crate rest, neurological functions worsen and are lost (leg movement and bladder control). STRICT crate rest is employed and after several attempts to go off of the anti-inflammatory, pain returns. If 100% STRICT crate rest has been employed and pain medications have been adjusted (dose, frequency, and mix of pain relievers), but the pain can’t be brought under control. If a dog is experiencing similar signs of neck or back pain, or mild neurological deficits for the 3rd or 4th time, meaning it may be the same disc is involved. f rom: dodgerslist.com/2020/02/10/surgery-vs-conservative/ |
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Post by Jessica & Roxy on Apr 28, 2021 21:04:26 GMT -7
I’m sorry! Here are more details —
Started Prednisone 4/25 at 5 mgs 2x/day. Vet said after today’s incident to stay at the 2x/day until we consult again tomorrow. One correction prednisone for today 5mg 3x per day for today.. Back to the regular 2x / day tomorrow per vet’s instructions after limping..
Rimadyl as of 4/17 STOP DATE? 4/23
4/23 AM dose was last dose of rimadyl —
gabapentin 50MG/ML: 30mgs (0.6mL dose) 2x/day STOPPED 4/28
We were doing 3x per day until today when we ran out.. She received approximately half a dose this morning. Then we had the limping incident at 5 PM while waiting for new meds. After incident vet upped dose.
gabapentin 100mg capsule: 50 mg giving 2x / day
methocarbamol 125mg twice per day
tramadol 1/4 pill 2x per day approximately 12.5 mg
Pepcid AC One half pill once per day approximately 5 mg per day
Thank you so much!!!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Apr 29, 2021 9:01:56 GMT -7
Jessica, thanks very much for filling in the details.
With both possible new neuro and new pain issues occurring BEFORE the test for pain taper would begin tomorrow 4/30, that could very well indicate there should not be a test taper. Instead that may well indicate another course of prednisone at the anti-inflammatory level 5mgs 2x/day should be prescribed.
It may take an anti-inflammatory 7 to 30 days before all swelling is gone. To date (4/29) with Rimadyl and prednisone there have been 7 days of anti-inflammatory use.
With liquid gabapentin running out on 4/28 that could be the reason for pain. However that would not explain increased/new neuro issues when there had been no change in the dose for prednisone. Also do not know if the vet observed and diagnosed the limping/favoring to be neuro damage or a sign of pain (root signature pain) See the list of pain and the neuro function list below. What did your vet diagnose?
On a pred taper or if the dog had moved too much, would be the typical cause of new/increased neuro.
As you know, there may or may not be nerve function improvements in the short time of 8 weeks dedicated to healing the disc. Nerve damage can take months to heal.
Pain when meds are correct, will be in control in 1 hour and stay that way right to the next dose.
URGENT vet visits
Any time out of the crate is a dangerous time for a dog going through an IVDD disc episode. Transport to a vet is risky as there is a chance of too much movement. Most vets who understand how STRICT the crate rest must be will understand that it's too much of a risk to bring the dog in to the office for a follow-up if it could be handled via a phone call. Find out if a call is prudent to give status updates on pain and neuro function via phone
With urgent vet visits, secure the crate in your vehicle. Transport carefully using a crate padded out with rolled up towels on either side of the dog to prevent movement or jarring the spine when braking or turning corners. 
MONITORING NEURO FUNCTIONS
As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order.
1. Pain caused by the tearing disc & inflammation in the spinal cord
2. ? Wobbly walking, legs cross
3. ? Nails/toes scuffing floor
4. ? Front or back paws knuckle under
5. Weak/little leg movement, can't move up into a stand
6. Legs do not work at all (paralysis, dog is down)
7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors.
8. Tail wagging with joy is lost
9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment.
NECK PAIN SIGNS
__?__ Root signature pain - limping, holding leg up like a flamingo, not wanting to bear weight.
__?__Looking with eyes only, not wanting to turn head, holding head up or down.
__?__Yelping
For an 11 lbs dog Pepcid AC (famotidine) should be 5mgs 2x/day. Please confirm what you are now giving. The usual dose during a disc episode is Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. Give the anti-inflammatory with a meal as added protection. www.1800petmeds.com/Famotidine-prod11171.html
Would you confirm your dog is not walking on a few steps to go out to potty vs. taking a very few footsteps during potty time. |
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Post by Jessica & Roxy on Apr 29, 2021 9:55:43 GMT -7
**Is it typical to remain on the steroid/pain meds for the 7-30 days? Is there any chance this will cause any side effects for her and what should I watch for?
Emergency vet diagnosed IVDD or possible neck injury based on palpation and physical assessment but no MRI/CT/X-ray..
The only symptom we’re seeing is #1 and a slight wobble occasionally when walking to go potty. No crossing legs, dragging feet, has good strength to stand and has good bladder control, tail wagging..
The first day we had yelping when picked up - The next day we went to the emergency vet and the yelping stopped at that point when lifted. At the ER vet she was tender on her thoracic spine under chest and didn’t want to then her head to the left or right. At that point she was stiff in her neck and holding it low. Since we’ve started meds all of those symptoms have gone away.
The only incident of pain we’ve had since was yesterday [4/28] with the limping on the right front shoulder, not wanting bear any weight on it. She’s looking much better today and is only walking [only fewest footsteps would be allowed!] to go potty but is not limping.. Such a relief!
This is good to know! Our vet said only once a day so that’s why we were doing that. We will ask today about this and start her now on the 2x per day Pepcid, starting today and going forward!
Yes, only very few steps.. When I put her down she usually takes a couple of steps each time and then she is carried back and forth from her crate..
Is there anything else we should be doing??
Thank you so much!!!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Apr 29, 2021 10:12:06 GMT -7
Jessica when posting via mobile device, I think this approach will make things easier for you: The Forum is best viewed via the "desk top view" of your browser app (Safari, Chrome, Foxfire)when on a mobile phone. As shown in picture below, you would scroll down to the bottom of the screen to click on "Desktop".  ** Reply to a post by scrolling down to the "Quick reply" typing area. Avoid using the "Reply" or the "Quote" link. Quick reply allows you to scroll up and down to a previous post and then back down to the "Quick Reply" typing area to continue your own post. A laptop or a tablet are, of course, much easier to deal with typing etc. if you have access to one. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Apr 29, 2021 10:31:40 GMT -7
Jessica, when we read "step" that equals red flag stairs to us. Footsteps means no walking just the very fewest of footsteps to take care of business. It's a vocabulary thing and the fact we can't see from our monitor's what is actually happening. We tend to read things literally. All questions we ask are now as of what happened on 4/28. The previous is history.
Was the wobble new/increased neuro function diminishment as of "Around 5 PM [4/28] I brought her out to go potty and she wobbled (neuro!), peed, and then was ▲ limping significantly (could be pain or neuro) and ▲ favoring her right shoulder (could be pain or neuro)."Is the wobbly you report today 4/29 more, less or the same than what was going on 4/28?
"The only symptom we’re seeing is #1 and a slight wobble"
It IS very typical that it will take 7-30 days on prednisone for all the swelling to be gone. Have you had a chance to bone up on the use of anti-inflammatories with a disc episode:
dodgerslist.com/2020/04/18/steroids-vs-nsaids/
--- Watch for signs of GI damage. Dogs don’t speak up at first signs of trouble like a person would. Signs of GI tract damage: dodgerslist.com/2020/05/06/stomach-protection/
--- Prednsone causes extra thirst, thus more urine production.
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Post by Jessica & Roxy on Apr 29, 2021 19:28:48 GMT -7
Hi Paula - Thank you for your help! The wobble is very minor.. Moreso when I first put her down to go potty the first couple steps wobble for a second while finds her footing and then she’s good.. Doesn’t look like she would fall just like it takes her a minute to get her footing.. I’m not seeing it every time I put her out.. I almost didn’t notice [wobble] it at first and then that’s when she limped on 4/28.. I hope that helps! It’s a bit hard to describe..
Do you feel that her prednisone/pain management dosing is typical and safe for her weight?
I had a friend that went through this and her doxy had liver damage due to prednisone so I am a bit worried after hearing her story.. Do you have any advice on side effects? We’ve been advised to keep on 2x/day through the weekend and then Monday begin the taper. I did read through the information you sent prior as well.. Is this a typical side effect.. I just want to make sure I’m warding off potential problems ahead of time! Thank you again!
[Moderator's Note. Please do not edit
11lbs 11 y.o.
crate rest started 4/20
Rimadyl as of 4/17 owner dosed
as of 4/19 12.5mgs 2x/day for 4 days STOPPED 4/23
No 5-7 day washout with switch, no doube GI tract protection (pepcid + sucralfate)
prednisone as of 4/25: 5mgs 2x/day for 5 days, 4/30 test taper 4/28 √pain for: /4/28 √ neuro
as of 4/28: 5 mgs 3x/day for 1 day
as of 4/29: 5 mgs 2x/day for 4 days; 5/3 test taper _pain/_neuro
gabapentin 100mg capsule as of afternoon 4/28 : 50mgs 2x/day
methocarbamol 125mg 2x/day
tramadol 12.5mg 2x/day
Pepcid AC 5mg 1x/day ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Apr 29, 2021 20:05:06 GMT -7
Jessica, prednisone for Roxy's weight is normal for the anti-inflammatory level needed ruing a disc episode. Roxy will have been on an anti-inflammatory level of pred for a total of 11 days this Sunday. Not out of the ordinary.... as the range could be anywhere from 7 to 30 days excluding any taper days in resolving swelling. If another course of pred would be needed you can request a blood panel to check the health of her organs.
Since the pred taper is a window into finding out if painful swelling still exists, meds that mask pain are stopped or backed off as you have read in the links provided. Taking the blindfold off allows a quick and more accurate assessment pain is really gone or not. It is the vet's call how the pain meds would be handled on Monday 5/3. This is important information for you to have. Also please let us know which:
--- a full stop of 3 pain meds (gabapentin, tramadol and methocarbamol) OR...
--- backing off of all three pain meds on 5/3
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Post by Jessica & Roxy on May 21, 2021 11:55:36 GMT -7
Hi Paula - I was hoping to check in about Roxy. Today she had a really bad pain flair up [5/21]. She was sleeping in her crate and when she went to move she cried. And then when she took a step she was really crying. She is walking normally from the little bit I can see in the crate but she didn’t want to be picked up to go bathroom. We had tapered totally off her prednisone as of 5/17. The five days before that she had been on only 1/2 a 5 MG pull every other day. At the same time we were tapering back her pain meds. All she was on as of today was Gabapentin about 75 MG per day split up over two times per day. I’m not sure if this is because of the taper or if she may have hurt herself again. I am so worried for her. She is resting comfortably now and is sleeping in her crate. After it happened I gave her 5 mg prednisone and her a full 100 mg gabapentin as that was the pain med that they recommended we keep on hand for a flair up. They said to do the ▲ prednisone 5 mg / 2x day now again and restart tapering.. does that seem right? They weren’t really clear and I’m having a hard time reaching the vet to talk and ask questions. [Moderator's Note. Please do not edit
12lbs 11 y.o.
crate rest started 4/20
Rimadyl as of 4/17 owner dosed
as of 4/19 12.5mgs 2x/day for 4 days STOPPED 4/23
No 5-7 day washout with switch, no double GI tract protection (pepcid + sucralfate)
prednisone as of 4/25: 5mgs 2x/day for 5 days, 4/30 test taper √4/28 pain/ √4/28 neuro
as of 4/28: 5 mgs 3x/day for 1 day
as of 4/29: 5 mgs 2x/day for 4 days; 5/3 test taper √5/21 pain/_neuro final taper dose 5/17 while on gabapentin 37.5 mgs 2x/day
as of 5/21: 5mgs 2x/day for 3 days, then see family vet to re-taper for _pain/_neuro
gabapentin ▲100mgs 2x/day
methocarbamol 125mg 2x/day STOPPED on 5/3
tramadol 12.5mg 2x/day STOPPED on 5/3
Pepcid AC 5mg 1x/day ]
I had been carrying her out to go potty on a cushion and keeping her horizontal to try to be as gentle as possible with her back. Is there a better way to carry her back and forth to go potty? She seemed hesitant to be picked up and I am worried I will hurt her more when I bring her outside Overall she is still physically moving just fine but is reacting like she is in pain. What else can I do for her? Should I restart the 8 week crate rest period? Are these flair ups normal part of the recovery process? Thank you so much for all your help and your quick responses. I am just a mess when this happens and I can’t tell you how much I appreciate being able to get advice. Thank you again — Jessica |
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Post by Romy & Frankie on May 21, 2021 13:28:06 GMT -7
I am sorry to hear that Roxy is having a pain flare-up. Flare-ups like this are not part of the normal process. It may be that the inflammation in the spinal cord never was completely gone and with the discontinuation of pred and the cutback of pain meds, this became apparent.
It is unlikely that one day on the full dose of pred will be enough to fully relieve the swelling in the spinal cord and thus the pain. She will probably need a longer course of it before another taper is tried. Tapers are usually tried every 5 to 7 days to see if the swelling has gone down yet. It is very common for dogs to have to taper
more than once. She will need the Pepcid AC 2x a day also.
Since Roxy is still in pain, speak to the vet about starting up the full dose of all the pain meds again. Pain will only slow the healing process.
One thing to consider is a pee pad right outside her recovery suite. That way, you won't have to pick her up or risk her taking too many steps to potty. |
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Post by Jessica & Roxy on May 21, 2021 13:50:12 GMT -7
Thank you for your thoughts - We have the pee pad set up for her to try and we will go back to the full doses of her prednisone and pain meds again. We’re going to keep a close eye on her. If the meds don’t seem to help would you recommend bringing her to the ER vet? She’s had them about 2 hours now, the first dose of pred and then the higher dose of pain meds. It’s been frightening as this was actually much worse that the initial pain at the start of this. She’s sleeping but seems stiff and uncomfortable, not her usual happy self. It really seemed to come out of nowhere, this morning she seemed great and now it’s like her shoulders and neck hurt again. Would you expect that the 100 mg Gabapentin would relieve this by now? She had that 2 hours ago and had a half dose this morning around 8 am. Thank you again - We so appreciate it. I am having a hard time getting a hold of the vets, we’ve tried two that she’s seen and they are just saying do the prednisone without much other input without bringing her in. The ER vet is 3 hours away which is fine but I am more so worried about transporting her, moving her, when she’s uncomfortable if they are just going to recommend the same as what we’re doing. Very hard to know what to do. Thank you again..
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Post by Romy & Frankie on May 21, 2021 14:19:58 GMT -7
Roxy should not be in pain. If she is still in pain two hours after the gabapentin than that is not sufficient and the pain meds should be readjusted. Consider adding back the two other pain meds she was taking earlier; methocarbamol and tramadol. Although pred will relieve pain by relieving swelling in the spinal cord this does not work right away. While the pred is doing its job, these pain meds should bring her immediate relief.
It is better not to transport a dog during an IVDD episode. There is always the chance of too much movement of the spine. Ask the vet who treated her before politely but persistently to prescribe the tramadol and methocarbamol again. There should be no need to bring Roxy in as that vet will have all her records. The ER should only be used if this vet will not work with you.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on May 21, 2021 16:57:00 GMT -7
Jessica, -- If you saw Roxy being rambunctious in her suite, at potty time that could be the cause of pain (retore the weak early healing disc). If she's been calm in her suite and then pain returned on the taper with gabapentin still on board at 37.5mgs 2x/day, maybe it was the test for pain taper that revealed spinal cord swelling still in existence. Hard to say. In one hr if the pain meds are correctly prescribed, Roxy should be out of pain. Call and strongly advocate all three pain meds be on board so that each of the three sources of pain are all covered. These pain med last for about 8 hrs. That is the reason vets Rx them at 3x/day. - traMADol-general analgesic. Advocate for maximum analgesic dose of 50 mgs every 8 hrs (3x/day). - methocarbamol- muscle spasm pain. Advocate for 125mgs 3x/day - gabapentin-nerve pain. Advocate for gabapentin 3x/day Adjusting meds by phone avoids a risky-to-the disc car transport. Describe what you observe to the vet. ⚙︎ shivering-trembling ⚙︎ yelping when picked up or moved ⚙︎ tight tense tummy ⚙︎ arched back, ears pinned bac ⚙︎ restless, can't find a comfortable position ⚙︎ slow or reluctant to move in suite such as shift positions ⚙︎ not their normal perky interested in life selves ➕if a neck disc: ◻︎ head held high/ nose to the ground ◻︎ 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 up flamingo style not wanting to bear weight QUESTIONSWhen you mention a med, it helps us to get what's going on when you give the details: date, mgs, how often. -- Prednisone. For how many days is Roxy to remain on 5mgs 2x/day?-- Had you already stopped methocarbamol and traMADol before the final pred taper dose?-- Do you have Pepcid AC 5mgs TWO times a day on board again?Call whichever vet you can get to help adjust meds. Since she has been seen by the ER vet, another vet on duty at that clinic can read her file andadjust meds without a risky vehicle trip in. LIFT AND CARRY to POTTY (support both ends, back horizontal to the ground) When you are able, please let us know about med changes (mgs, frequency) and that Roxy is back in comfort within the hour of med adjustments. Hope this need not wait til your vet is open Sat morn. He also should be able to adjust meds over the phone first things Sat morn/ |
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Post by Jessica & Roxy on May 22, 2021 9:04:26 GMT -7
Thank you both for your input. Roxy seems more comfortable today with the 3x/day Gabapentin and back on the 2x/day 5mg prednisone. She is still laying stiff with her neck, eyes looking up but not moving neck. When she first woke up she was moving her hind legs a bit up and down as she was laying which was odd. That seems to have subsided though now. I am worried it may have been a neurological issue as it seemed more like a tick/involuntary. I sent a video to the Dodgerlist Facebook messenger as I wasn’t sure how to send on here. We’re just keeping her quiet in her suite right now. I’ve been trying to reach vets for input but am having such a hard time. We called the ER last night and they said they couldn’t give advice without seeing her [ER vet] and that because she had been seen by urgent care before which is technically a different department that we’d have to reach out to Urgent Care instead. So this morning I called urgent care when they opened and they said they can’t talk to me without seeing her again even though the first visit was less than a month ago. So very frustrating. I expressed to them that we’d been advised not to transport her unnecessarily and they did not seem to care. Our primary vet is not open on the weekend.
We called an different emergency vet for input last night. They said the couldn’t prescribe without seeing her but thought that as long as she’s comfortable enough to rest and not getting worse to keep her on the meds she’s on currently instead and assess after the weekend with primary vet.
I’m just not sure what to do. She seems okay, sleeping - Just very guarded in her posture.
I’m going to call back and ask urgent care to send me her blood work from the original medication prescription as I’m a little worried about restarting the meds again without knowing how it will affect her side effect wise. They said everything looked good originally so I’m hoping this second round of meds wouldn’t harm her and would do more good than bad.
She is still eating, drinking, pooping, walking normally when going bathroom. Yesterday she was very sore getting up from laying down and when being picked up. Today seems a little better but she hasn’t moved around much and I’ve only picked her up once to go potty VERY carefully. I also was reading last night regarding cervical IVDD vs. spinal IVDD. Is it correct that pain is more common with cervical than the inability to walk? I read that surgery should be considered when pain isn’t manageable. Is that correct? Should I be concerned this happened so soon with conservative treatment? I’m so sorry for all the questions. You guys have been such a valuable resource and I’m just trying to do everything I can. Thank you again so much.
Roxy had a pain flair up yesterday of cervical IVDD and it was worse than the initial injury.. she’s on pain meds and prednisone.. still uncomfortable.. when she woke up this morning she was doing these little kicks with her back leg and I am wondering if it is neurological and requires immediate attention.. any thoughts appreciated as we try to reach vet
Sorry I missed the questions - We were told to do 2x/day prednisone 5 mg over the weekend until we’re able to talk to our primary vet on Monday. That was from a different vet at the clinic. They had support staff call and I wasn’t able to talk to them. Also frustrating! Metho/Tram stopped when prednisone did and they kept her on Gabapentin. And she has been getting the Pepcid AC 2x/day since this was first referred by Dodgerslist. We never took her off of it as a precaution.
This is the leg movement that I was referencing 7:13 MST 5/22: Roxy had a pain flair up yesterday of cervical IVDD and it was worse than the initial injury.. she’s on pain meds and prednisone.. still uncomfortable.. when she woke up this morning she was doing these little kicks with her back leg and I am wondering if it is neurological and requires immediate attention.. any thoughts appreciated as we try to reach vet
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on May 22, 2021 10:17:56 GMT -7
Agree with ER Vet who said blood work normal as of 4/19, likely health of organs has not changed todate.
If you still have the methocarbamol and traMADol, restart them at the Rx'd dose so that all three sources of pain are being addressed
- methocarbamol for muscle contraction pain typical with a neck disc: 125mgs 2x/day
- tramadol as the general analgesic 12.5 mgs 2x/day
- gabapentin for nerve pain 100mgs 2x/day
- prednisone 5mgs 2x/day over the weekend until you can reach your family vet over the phone.
- Pepcid AC 5mgs TWICE a day
So we know, please be precise in confirming what you are now going to give.
Please let us know within the hour or less of being back on the Rx'd doses, all pain if fully in control.
The video of a black dog, black eyes is hard to tell if she was wakened and was going back to sleep (eyes closed)? Was she dreaming then if eyes closed. Dreaming with leg movement would then be brain to leg directed movement.
I also saw in the video that she appeared to be licking her chops. That could be one sign of pain. Or it could be being thirsty. When videoing try to have good lighting to show the black fur on black eyes, the mouth and leg activity.
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Post by Jessica & Roxy on May 28, 2021 14:36:35 GMT -7
Hi Paula - We now have pain back under control - This last week we did [Dates 5/21-5/26?] pred 5 mg 2x/day. We [5/27] tapered to once a day yesterday. Confirming Pepcid, Tramadol, Methocarbamol restarted at the doses listed above as of Tuesday. She was painful over the weekend - Hesitant to be picked up, stiff neck, not lifting head only eyes. It got better as the week went on with pain medications and prednisone back in place. She is s till somewhat hesitant to be picked up but no crying and less stiffness than before.
[Moderator's Note. Please do not edit
12lbs 11 y.o.
crate rest started 4/20
prednisone as of 4/25: 5mgs 2x/day for 5 days, 4/30 test taper √4/28 pain/ √4/28 neuro
as of 4/28: 5 mgs 3x/day for 1 day
as of 4/29: 5 mgs 2x/day for 4 days; 5/3 test taper √5/21 pain/_neuro final taper dose 5/17 while on gabapentin 37.5 mgs 2x/day
as of 5/21: 5mgs 2x/day for 7 days, 5/27 test taper √5/28 PAIN
gabapentin 100mgs 2x/day?
methocarbamol 125mg 2x/day?
tramadol 12.5mg 2x/day?
Pepcid AC 5mg 1x/day ]Today [5/28] we did consult with a specialist at the University of MN for some additional input on why her pain is persisting. She noted neck pain still [5/28] today even with the medications upon assessment. We discussed conservative vs. surgical approach. She said Roxy is a grade 1 as her only symptom is cervical pain. However because it is persistent she may be a surgical candidate. She recommended a MRI as follow up and to determine whether surgery is needed at that point. Can you share some information on making the decision for surgery vs. conservative? I am very nervous about it as Roxy is 11 so any time being put under anesthesia is worrying. She said she could be comfortable with long term steroids and pain meds without surgery but that flair ups may happen in the discs effected and that they might progress her disease. I’m wondering if it makes more sense to fix the issue with surgery before there’s a chance it progresses and she’s older at that point. At the same time, very nervous to do the surgery as she seems ok when medicated but I’m not sure that that’s healthy to remain on long term either, especially if the vet is palpating pain even with all meds in place today I am very sad for my sweet friend! Any advice on surgery would be really appreciated! I reviewed a lot of information on the conservative approach but do not feel well informed about surgery. Is there anything adverse I should be aware of? Thank you so much again for all your help - I so appreciate being able to talk to someone about this who understands— Jessica & Roxy |
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Post by Romy & Frankie on May 28, 2021 15:25:06 GMT -7
Is Roxy only showing pain on the vet's examination and not at other times? I ask this because your first sentence is "We now have pain back under control". If she is showing signs of pain the taper should be stopped and she should be back on the full dose of pred. It can take a total of 30 days on the full dose of pred before all the swelling is resolved. Looking back it does not seem that Roxy has been on the full dose of pred for a total of 30 days. A dog is a candidate for surgery if several tapers have been tried but the pain remains. However, if Roxy has not been on the pred for a total of 30 days I think considering surgery may be premature. Surgery can help with the current disc issue, but cannot prevent a problem with other discs. Many dogs have only one disc issue some dogs have more. There is no way to tell. Roxy may have addition disc issues with or without surgery. An MRI is usually done shortly before surgery so the surgeon know where to operate. . For dogs being treated conservatively all discs are treated at the same time so an MRI is not really necessary. Imaging might be in order if the vet thought the symptoms might be caused by something other than IVDD. I am not sure if you have had a chance to look at the information here at the link below. I hope it will help you make the decision. dodgerslist.com/2020/02/10/surgery-vs-conservative |
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Post by Jessica & Roxy on May 28, 2021 15:41:02 GMT -7
Okay thank you for this info - That is good to know! She was painful through the weekend and then I didn’t notice anything this week on the full dose of pred 2x/day. So the pain was just on palpation [at University of MN vet 5/28] I think. She does seem a bit tired/stiff now again that she’s home so I’ve given her next pain med dose. We’ll talk to the vet about continuing a full dose of prednisone for 30 days - Would that be the 2x/day for 30 days or does that include the taper?
The vet believes that it is a disc issue as it started with a jump from the couch that landed poorly. However she did say that there could be other causes - Possibly auto immune disease or cancer that she hasn’t ruled out. She talked about a CTSS test for auto immune but that would require that she be off of prednisone for a week prior to the test, which we agreed doesn’t seem to be a good idea as she was in pain without the prednisone.
Thanks so much for your input -
Jess
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on May 28, 2021 16:07:48 GMT -7
Jessica, prednisone is very unlike other medications. Having a bit of background on how pred is used during a disc episode will help you sort things out better: dodgerslist.com/2020/04/18/steroids-vs-nsaids/Be informed about surgery: **  Dr. Isaacs answered alot of questions we've had about surgery: "Surgery needs to be a decision an owner enters into recognizing the risk, but also recognizes the benefit. This way if something unforeseen occurs an owner can be comforted and at peace with the fact that surgery was the right decision and they did all they could for their dog." You will find it worthwhile to read the rest of his answers about surgery: dodgerslist.com/2020/05/12/dr-isaacs-surgery-answers/More excellent info to help with conservative vs. surgery decisions: dodgerslist.com/2020/02/10/surgery-vs-conservative/No dog would be on the anti-inflammatory level of prednisone for a straight 30 days. The prudent thing vets do is to dose one course for a 7- or 14 days course, then taper. Taper days do not work on swelling. So it may take several anti-inflammatory courses adding up to somewhere in the range of 7 to 30 days before all swelling proved gone when the taper starts. See the underlined days below? Roxy has been on anti-inflammatory pred for seemingly 16 days with many tiny short courses. MED LIST for PREDNISONE confusion in pink12lbs 11 y.o.
prednisone as of 4/25: 5mgs 2x/day for 5 days, 4/30 test taper √4/28 pain/ √4/28 neuro
as of 4/28: 5 mgs 3x/day for 1 day
as of 4/29: 5 mgs 2x/day for 4 days; 5/3 test taper √5/21 pain/_neuro final taper dose 5/17 while reminaining on gabapentin 37.5 mgs 2x/day
as of 5/21: 5mgs 2x/day for 6 days, then test for pain taper 5/27: √5/28 PAIN
What date did the 5/21 pred course taper to lower than 5mgs 2x?day? on Thurs 5/27?
If my dog I would would advocate an aggressive typical longer day-course approach with prednisone. ---Prednisone for a 14-day course AND then another test taper for pain ---All 3 pain meds on board for the 14 day promptly every 8 hrs (3x/day) Pain meds last about 8 hrs in the body that is why 2x/day is not sufficient to fully control pain. IF this is the current for pain meds AND it is fully providing comfort that would be good. IF NOT, then advocate for 3x/day pain med dosing - traMADol 12.5 mgs 2x/day - gabapentin 100mgs 2x/day - methocarbamol 125mgs 2x/day ---PEPCID AC 2xDay for the duration of Predsnione Tell us what YOU are seeing now at home regarding pain surfacing nearing next dose of meds or when having to move with the current meds/doses/frequency now on board.
Neck discs just are more painful and may take longer to get all the swelling resolved. When most any part the body moves, the neck discs usually also will need to move. Avoid unnecessary, non urgent vet visits. The single most important care you can give is the at-home in the recovery suite STRICT rest. Phone updates about pain, about diminishment of neuro functions can often be handled by phone. Vets who know IVDD understand the need to keep the back/neck from rise transport potential to be moving too much. |
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Post by Cindy & Charli on Jun 6, 2021 6:11:29 GMT -7
Hi, Jessica - I have read through your posts and my heart aches for you and your Roxy. I am not a vet - and certainly defer to the amazing moderators here on Dodgerslist, as well - but was wondering a few things...
1) Is there a mobile vet available in your area? We were fortunate to find one that would work in conjunction with our primary vet - and it was a very helpful partnership that kept us from having to transport our Charli to the vet.
2) Have you tried acupuncture? I have had 3 dachshunds over the years with neck IVDD issues (used to foster for a dachshund rescue - so we always ended up with the sick ones). When Charli (our 3rd to suffer IVDD) was injured, my rescue friend said "FIND AN ACUPUNCTURE VET NOW!" I was skeptical - and conferred with my primary care vet. Did some research and found a great vet that came to our home to do therapy. Has made a HUGE difference in recovery compared to other two dogs in the past. Understanding that every dog is different - I have no idea if your sweet Roxy would respond as well or not - but it will be immediately added to our treatment protocol if there are any future events with Charli or our other two dachshunds.
3) Vet-prescribed CBD oil has also been a great addition to Charli's prescribed medications. Again - it is not something I had been willing to try before - but in Charli's case, we were willing to try anything to make her comfortable. Again, we conferred with our primary care vet (who does NOT house CBD oil) and he enthusiastically agreed that it would be worth trying. Luckily, the mobile vet WAS a provider of prescription CBD oil - so that worked out well. This is a veterinarian prescribed and dispensed medication - not something purchased over-the-counter.
4) Cold-laser therapy. Also a tip from our dachshund rescue friend - and something the mobile vet could provide. They came and did an initial treatment - and then we were able to rent the unit for daily therapy (in Charli's case) - for two weeks. Charli is now on a once-a-week treatment - so we pick up the unit for a day - or the mobile vet can come and do the treatment if we want them to assess progress or adjust therapy.
Having had dachshunds in my life for over 40 years, I've only in the past 15 had to deal with back issues. Even still - as an "old dog" myself, some of the therapies I mentioned above I had considered "witch doctoring" - until I saw the proof with Charli.
Please do the research yourself - and confer with a trusted vet - for what is available and what would be best for your Roxy. But I would hate to think that any of the folks that offered me advice (that turned out to be VERY helpful with our Charli) would have kept quiet in order to not appear "weird" or "out of the box" for treatments.
I could hear the desperation in your writings - and my heart hurt for you and your baby. I hope something above might give you some options.
Sending hugs to you and Roxy - and big wishes for improvement and freedom from pain.
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Post by Ann Brittain on Jun 6, 2021 7:25:41 GMT -7
Since we haven't heard from you for a few days, it would be good to get an update on Roxy. You'd mentioned that the vet had considered causes other than IVDD for her pain.
I agree with Cindi that there are some alternative treatments. As she mentioned, you should only start them after consulting with a vet.
Buster had acupuncture and cold laser treatments several weeks after surgery. It was necessary for me to hold him while while the vet inserted the needles. Then he had to remain still for a few minutes until the needles were removed. The cold laser treatments also required him to remain calm. You know best how your dog responds, but I would be cautious if she has a tendency to resist or squirm.
We believe Buster's conditioned improved after these treatments, but there's no way to know if he would have made the same progress without them. Although my sister, who was a nurse, was able to overcome chronic knee pain after she had acupuncture.
Hope Roxy is doing better.
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Post by Jessica & Roxy on Jun 14, 2021 11:58:05 GMT -7
Hi everyone - Thank you so much for your kind and helpful responses. Roxy began her second tapering of Prednisone on May 21st. 2 5mg pills 2x/day for 5 days. Then one pill a day for 6 days. Then 1/2 pill a day for 6 days. And now we're on our 5th day of 1/2 a pill every other day today. She's remained on her pain medication and pepcid and has been comfortable. [Moderator's Note. Please do not edit
12lbs 11 y.o.
crate rest started 4/20
prednisone as of 4/25: 5mgs 2x/day for 5 days, 4/30 test taper √4/28 pain/ √4/28 neuro
as of 4/28: 5 mgs 3x/day for 1 day
as of 4/29: 5 mgs 2x/day for 4 days; 5/3 test taper √5/21 pain/_neuro final taper dose 5/17
as of 5/21: 5mgs 2x/day for 7 days, 5/27 test taper √5/28 PAIN
gabapentin 100mgs 2x/day?
methocarbamol 125mg 2x/day?
tramadol 12.5mg 2x/day?
Pepcid AC 5mg 1x/day ]As far as our current observations, I'm not seeing pain resurface when the next dose is due. She has remained slightly hesitant to be picked up but is not whining or crying. We've been trying to pick her up on a pillow or cushion so as not to put any pressure on any one area. Though she historically has seemed the most sore in her shoulders/neck area. Over the last two weeks, she's become very restless.. Whining, barking, crying in her crate.. Just heartbreaking .. Though I don't think she is painful as she's moving around really well, have had no issue at potty time, and no pain resurfacing. This is similar to how our first go round went when she was on the prednisone as well. About a week ago, we noticed that she's been aggressively scratching her face before and after drinking.. We're not sure if a side effect from medication or something to do with drinking itself.. We did arrange her water dish according to the cervical neck tip article on this site in hopes that it would help her.. This behavior also happened before the last flair up after the last taper so I am worried for her but am relatively hopeful being that she seems happy and comfortable.. Thank you all so much for your thoughts and comments - We so appreciate it.. It's been very stressful worrying about our Roxy and we appreciate all the positive thoughts and comments so much! I wasn't aware of the option for a mobile vet, but I will certainly look into that in our area! That seems like it may be a wonderful resource to incorporate so we don't have to move her. And the same with acupuncture, we haven't tried it yet with her and I'm unsure what we have in our area but given both of your positive experiences, I'll look more into it for her.. Anything non-invasive w/ the potential to help, we are willing to do for her.. We're willing to do whatever she needs to get better.. We have started incorporating cold laser treatments for her now as well.. She's currently receiving treatments every other day in our home.. We were able to rent a unit to have at the house so that's been a big help.. I have also heard great things about CBD though we haven't yet tried it, and I like the idea of a prescribed medication rather than an over the counter supplement.. I will ask out vet about that option as well and see if that have that available for her.. We also are trying a few supplements - VetriDisc, Dasquin, and Petandim. We also tried a calming supplement for her called Composure through Vetriscience because she does get nervous in her crate, it seemed to help some days.. Tomorrow marks 8 week crate rest for Roxy.. We've been strict with it and tried to limit her movement as much as possible.. We're scheduled for a follow up appointment at the University tomorrow for a neurological assessment to see where things are at tomorrow.. They're recommending an MRI if she is still painful after the 8 weeks and 2 pred tapers.. They said the MRI would tell us if she'd heal appropriately with conservative treatment or whether we should look at surgery.. They also said that the MRI would rule out any tumors or auto immune issues as well.. I apologize I haven't responded as quickly, the waiting has been very stressful thinking about the potential for surgery so it's all felt a bit overwhelming.. We believe Roxy is 11 but she may be older as she was adopted from the shelter.. I'm just hoping if she needs surgery that she'll handle it okay.. Thank you again for sending the surgical resources as well -- I've taken time going through all the resources I can find so I am prepared to make a decision for surgery and know what to ask if that is something that is recommended for her.. Please keep us in your thoughts Jessica and Roxy |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Jun 14, 2021 15:17:55 GMT -7
Jessica, you don't have any idea!
Why you don't have any clear idea of the status of painful inflamed spinal cord nerves.
1) Having pain meds still today on board (gababentin 100mgs 2x/day, methocarbamol 125mgs 2x/day and traMADol 12.5mgs 2x/day) covers up pain. In other words you have a blind fold on about the root cause of pain.
2) Pain's root cause is the inflamed tissue around the spinal cord.
3) The swelling will not be resolved until Prednisone —up at the original anti-inflammatory level (5mgs 2x/day) —completes the job. No one can know the truth UNTIL....
A) Prednisone goes to taper doses which are no longer working on swelling
B) All pain meds the very same day the pred taper starts are 🍫backed down to lower and lower doses or 🍫full stopped
Not stopping pain meds (nor a quick backing off) on the date the pred taper began means, a delay in finding out the truth. Is all of Roxy's painful swelling really gone or not? It means a delay in another course of pred if it would be needed.
What is not important is how many tapers there are. What IS important is the number of days on prednisone. No prudent vet would just Rx a straight 30 days of pred. Prudent vets try a 7-day maybe a 14-day pred course. Then the test for pain tapering of pred. It will take in the range of 7-30 days before all swelling is gone. So far Roxy as had 4 prednisone courses of 5-, 1-, 4- and 7-days. In other words a total of only 17 days on prednisone at the anti-inflammatory level of 5mgs 2x/day.
No dog should be off of crate rest until it is proved all painfully inflamed nerves have been resolved by prednsone. Normally the dog would be off of all meds at least a week prior to graduation to ensure pred had done its work.
Let us know what the $1500+ MRI rules out
-- regarding if U of MN are highly suspicious of a different disease
-- if the neck disc has self healed properly to shrink back away from the sensitive nerves
-- if the swollen nerve tissue has be resolved fully by prednisone.
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Post by Jessica & Roxy on Jun 15, 2021 9:44:40 GMT -7
We just heard back from the vet regarding Roxy’s MRI - She saw a board certified neurologist at the U of MN.. The doctor said that clinically she presented really well! They said there was very little pain on their neurological assessment.. Heart/lungs/abdomen all looked good.. No neurological deficits.. They thought she has an excellent prognosis which was so wonderful! Her concern was that the medication could still be masking pain so she still recommended the MRI.. She said Roxy has a bulging disc at C4-5 and C5-6, with minimal spinal compression at C5-6.. Based on the results she is recommending no surgery and to continue with conservative treatment.. she’d like us to taper both the prednisone and pain medication now to get a true feel of her comfort level when not medicated.. So Roxy will come home tonight and we’re going to give it a try! Cross your fingers for us that the pain doesn’t return! They said if she becomes painful to give her her medications again, and that at that point we’d be looking at surgery.. I’m a little nervous given how painful the last flair up was with no meds so really hoping this time will be better.. Would be wonderful if we’re getting healed up! She’ll remain on crate rest now until we get a clear picture of what she’s like without medication.. If she were to be okay without surgery, do you have any advice on the transition from the crate and back to normalcy? We keep her on one level of the house.. There is only one couch that she likes to go up on during the day and we’ve bought ramps to cover the whole surface of the couch so she can’t jump anymore.. Are ramps safe once they graduate from crate rest? Is there anything else we should be doing additionally or any thoughts on how much exercise she can have once she’s safe to move around again? We’re crossing our fingers for little Roxy!! Let’s hope she stays comfortable— Thanks so much - Jessica
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Jun 15, 2021 10:44:22 GMT -7
Hmmm, so basically you are saying transport into the vet exam yielded no useful information because medications were still on board blindfolding everyone about the true status whether all painful spinal cord swelling had actually been resolved or not! How Prednisone is used during a disc episode: dodgerslist.com/2020/04/18/steroids-vs-nsaids/This was a non-dangerous and very useful opportunity for you to learn a real life lesson. Living with an IVDD dog, means that at times because you have done the work getting up to speed on IVDD, you'll need to present information and strongly advocate on behalf of Roxy. Looks like we are out of the loop on current meds with your saying Neuro wanted prednisone to start tapering. The test taper did not start on 5/27?
Roxy has been on 5mgs 2x/day since 5/21 til June 15th?
What will be the date of the last dose of prednisone?
What are the current pain meds given? gabapentin 100mgs 2x/day methocarbamol 125mg 2x/day tramadol 12.5mg 2x/day What does the neuro want them to be reduced to? Pepcid AC 5mg 1x/day until prednisone is fully stopped. We do have lots of information and tips to share with you about how to gradually and safely introduce Roxy back to family life. Please let us know when all meds have been concluded so Roxy can get to work on regaining life with family. |
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We received our diagnosis [4/19] today after my 11 yr old mini dachshund Roxy jumped from the couch [4/17] and landed poorly on Friday and developed symptoms over the weekend.. We are so grateful for the help and insight.. I want to act quickly to prevent further damage.. 
