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Post by Melissa & Stretch on May 1, 2021 20:48:10 GMT -7
Please do not edit this post. Additional info or corrections should go in a new post. THANKS!
[Original subject line: Melissa/8 y/o daschund Stretch]
My Stretch had back surgery 3 years ago and it was successful. He was completely back to normal until a couple weeks ago  On April 14th I noticed he wasn’t walking normal and acting painful. Started him right away on crate rest and prednisone which I had since the last small flare up after surgery. Fast forward to today May 1st he is still currently on crate rest and still whines and whimpers in pain, I have been taking him out to go potty which he still has full function of bladder and bowel. The pain and anxiety are the worst part for him, I currently have him on prednisone 5mg once a day, gabapentin 100mg 3 times per day, robaxin 500mg 3 times per day, tramadol 50mg 3 times per day. Also he is on cbd oil which he has been on daily for the last 3 years since surgery. He was on the prednisone 2 times per day and now we are down to [pred] once per day to gradually wean him down. [Moderator's Note. Please do not edit
20.5 lbs 8 y.o
prednisone as of 4/14: 5mgs 1x/day (taper dose!) for ? days, √5/1 pain / _neuro
gabapentin 100mgs 3xday
Robaxin 500mg tab: ?mgs 3x/day
tramadol 50 mgs 3x/day
trazodone, not given
CDB oil
needs GI tract protector, Pepcid AC, on board w/prednisone! ]
He cannot walk or stand on his own and I really haven’t let him even try since he’s on strict crate rest. The vet also prescribed trazadone for his anxiety which I haven’t given every day since he’s on the tramadol. Sometimes he just cries and whimpers for hours and I don’t know what else to do when this is occurring, I try everything. He does seem to pant a lot as well during these episodes and also lick him paws constantly during a painful episode it seems. I know it’s going to take a lot more time and work to get him out of pain, just wondering if I am doing all the right things? Or is there something more I can do for him until the disc or discs start to heal. Thank you, Melissa
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Post by Melissa & Stretch on May 1, 2021 21:33:09 GMT -7
☆ 1 pain? Yes still having pain
☆ 2 How much does your dog weigh? 20.5lbs
B.. steroid start date & dose? 4/14 and currently still on 5mg once per day
☆ 3 -- appetite is good and eating fine
☆ 4 What breed? Daschund, his name is Stretch, I am Melissa
☆ 5 Per vet he thinks based on symptoms it’s another ivdd flare up, no imaging completed -vet is a general DVM
☆ 6 CONSERVATIVE treatment? 4/24 and 4/27
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on May 1, 2021 21:33:43 GMT -7
Welcome Melissa! Additional answers will help us give better comments. See below. When prednisone goes to a taper, that is "the TEST" to find out if there is still pain and if any new neuro diminishment. So your reporting pain, should indicate to the vet it is not time to taper prednisone. But instead call for another course (maybe a 7- or 14-day course) and then try another test for pain pred taper. Gain an understanding of how pred is used during a disc episode. Will be helpful when discussion things with your vet: dodgerslist.com/2020/04/18/steroids-vs-nsaids/LICKING paws, genitals can be a sign of neuropathic pain. Gabapentin often does help. Since it is not, call the vet in the am or go to ER if need be to go with the stronger, newer generation Lyrica Everyone has experienced numbness or pins and needles tingling in your legs when sitting in a bad position for too long a time. Your dog can be feeling abnormal nerve sensations that are mild pins and needles to quite painful burning, on-fire feeling that makes them bite to stop the pain. These are abnormal signals explaining why a paralyzed dog can feel this neuropathic pain. Learn more: dodgerslist.com/2020/06/10/neuropathy/ You would need to stay on top of observing for any more signs of chewing on body parts as this can lead to death. Immediately put a e-collar on or a lengthwise folded towel and secured closed with duct tape. PANTING can be a sign of pain and it can be caused by prednisone. Hopefully getting back up on the original anti-inflammatory dose will stop the panting if pain. If not pain try: 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. -- Neurologist, Dr. Isaacs discusses this issue on the Dodgerslist Neuro Corner www.dodgerslist.com/neurocorner2/panting.htmPEPCID 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. Proactive vets don’t wait til there are red flag signs of: lip licking of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers, red or black blood in stool due to the extra stomach acids anti-inflammatory drugs cause. 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). HEALTH ISSUES: Mar Vista Vet reports: "Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients.” QUESTIONS-- weight of your doxie?-- How many mgs of Robaxin is one dose? The whole tab is 500mgs.-- Do you know the effects CDB oil may have on the big gun IVDD meds? -- Had the pain ever been under control after the start of the 4/14 meds? If yes, then what date did the pain surface? Does it surface nearing the next dose of pain meds (gabapentin, robaxin, and tramadol)?-- Discuss this with your vet and consider whether to continue CDB oil in light of big gun IVDD meds being on board. Read why here: dodgerslist.com/2020/02/24/devices-supplements/%E2%80%8B?highlight=CDB%20oil-- What was the prednisone dose Rx on 4/14: ?mgs ?x/day and for how many days? Those days are the important part of prednisone. Those are the days this med is actually working on painful swelling in the spinal cord. Taper days are too low. If swelling still exists it will rise up and cause the dog pain.
-- Detail his neuro loss:
⚙︎ Can he move his legs at all such as to reposition in the recovery suite?
⚙︎ Do his back paws knuckle under?
⚙︎ Can he sniff an old pee spot in the grass and then make the choice to release urine there? OR does he leak on you when lifted?
⚙︎ Are you on the same page about what STRICT rest:
STRICT means:
◼︎No laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you
◼︎No chiro therapy whys: dodgerslist.com/2020/04/22/chiropractic/
◼︎No dragging or meandering at potty times.
◼︎No PT for conservative dogs during 8 weeks to heal disc
◼︎At home laser or acupuncture for severe neuro damage is best.
◼︎ Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. Consider home visiting mobile vet if these therapies are wanted.
◼︎ Avoid dangerous detours. Follow the "Roadmap." Tape it to your fridge. D/L and print out: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf
◼︎ How to tips and ideas to make the rest period go smoother:
dodgerslist.com/2020/05/14/strict-rest-recovery-process/ |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on May 1, 2021 21:52:14 GMT -7
Melissa, for a 20.5 lbs dog, Stretch has been prescribed a taper dose on 4/14. Call and advocate for using the anti-inflammatory level dose of prednisone. Ask if there is a health reason for using less than an anti-inflammatory level dose? Depending on the dosage, steroids can be replacement steroid hormone in dog not able to make sufficient hormone, can function as anti-inflammatory drug during a disc episode or provide immunosuppressive effects for auto immune diseases, etc. NOTE: Prednisone should never be prescribed by owners. It is the vet's job, because of his training, knowledge of dog's health history owners and other may be aware of 20.5 lbs Stretch X 0.3mgs pred = 6.15mgs pred dose. Since pills come in 5mgs, a vet will often round down to 5mgs 2x/day
What was the reason for a vet visit on 4/24 and then another on 4/27? What action did the vet take on each of those visits? Could it have been addressed via a phone call to avoid a risky to the healing disc transport of too much movement?
Would surgery be a consideration for your family if at some point it were to be indicated? |
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