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Post by Darla & Gizmo on Jul 23, 2021 21:05:01 GMT -7
[Original subject line:Gizmo ]
My name is Darla. Gizmo is my 9.5 year old dachshund. He weighs 13.14 lbs.
MEDITATION Tramadol, 25mg every 8-12hrs Galliprand, 10mg per day Gabapentin, 100 mg per day
[Moderator's Note. Please do not edit 13.14 lbs 9.5 y.o. galliprant as of 7/19: 10mgs 1x/day for 14 days, then 8/2 test STOP for: _pain / _neuro gabapentin 100mgs 2x/day traMADol 25mgs 3x/day needs GI tract protector, Pepcid AC, on board w/Galliprant! ]
-- No official diagnosis. -- DVM (emergency) -- Mon, July 19 -- Some signs of discomfort. -- Good ambulation while walking and urinating. -- Eating and drinking well. -- Good bowl movements.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jul 23, 2021 21:22:23 GMT -7
Welcome Darla! Glad you are here. Emergency FAQ will fill you in on the big picture about caring during a disc episode: dodgerslist.com/2020/02/24/emergency-faq/It will help us work together with you and avoid offering ideas that could cause harm or lead the discussion in the wrong direction delaying help for your dog — please share a bit more detail with us: QUESTIONS Does Gizmo have any heath issues, taking any other meds? ☆ 1 Is there currently any pain? Tell us what you observe ☐ reluctant to move much in crate such as shift positions or slow, ginger movements ☐ shivering, trembling ☐yelping when picked up or moved ☐ tight tense tummy ☐can’t find a comfortable position, appears restless ☐ Arched back ☐head held high or nose to the ground ☐ Holding front or back leg flamingo style not wanting to bear weight ☐Not their normal perky selves? Full pain relief is expected in1 hour and stays that way dose to dose. If not in control your vet needs to know asap to adjust meds. ☆ 2 -- For how many days will galliprant be used? -- Which do you actually give traMADol every 8 hrs or 12? IT should be promptly every 8 hrs. -- Gabapentin should also be every 8 hrs. ask the vet if that option is not printed on the bottle. PEPCID AC: Phrase a simple question that you expect a simple "yes "or "no" to it. Does my dog have 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). (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 ** ☆ 5 Did the ER say anything about a disc problem, a disc herniation, a bulging disc, slipped disc? -- What caused you to bring him in to see a vet? -- What did the vet say the meds would improve with ER’s “no diagnosis”? -- Let us know how you have your recovery suite set up: -- Super tried and true tips for setting up the recovery suite, the mattress and more! —> dodgerslist.com/2020/05/14/strict-rest-recovery-process/ STRICT rest means limited movement of the spine: - no laps - no couches - no baths - no sleeping with you - no dragging or meandering at potty times. - no PT - no chiro therapy: Read why Chiropractic is not recommended for an IVDD dog: dodgerslist.com/2020/04/22/chiropractic- 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. - 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 ROADMAP ☆ 7 DOGs with BLADDER 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 When taking some footsteps (no walking around allowed) do the paws graze the ground? Do the paws knuckle under. OR if knuckled can your dog right them properly on the ground? Look forward to your answers so we know best how to assist you with caring for Gizmo at home. EMAIL ALERTS Timely communications are needed when helping your dog. How set up a bookmark for your dog's thread for email alerts when you have received a reply: dodgerslist.boards.net/thread/7353/register-bookmark-dogs-post-thread
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Post by Darla & Gizmo on Jul 24, 2021 12:17:03 GMT -7
**DATE OF EXAM/START OF REST 7/19 not 7/10** Health issues: Gizmo has a lways had a sensitive tummy-diahrrea and skip meals when he's eaten something new or too rich. Also he had allergic reaction to puppy inoculation and continues to have reaction to pollens; severe swelling in face and I give him 12.5 mg of diphenhydramine [generic for Benadryl. [Moderator's Note. Please do not edit 13.14 lbs 9.5 y.o. galliprant as of 7/19: 10mgs 1x/day for 14 days, then 8/2 test STOP for: _pain / _neuro gabapentin 100mgs 2x/day traMADol 25mgs 3x/day diphenhydramine (generic for Benadryl) 12.5 mg needs GI tract protector, Pepcid AC, on board w/Galliprant! ]Pain: ? Some shivering and just seems depressed. Meds: Galliprant 14 days, Tramadol every 8 hrs Gabapentin Rx label reads "1 capsule twice a day (every 12 hrs)" His reg vet is a low cost mobile one. Free exams, high cost vaccines. ER did mention a possible disc problem in the neck but I forgot what specifically, didn't write it down because I thought it would would be in paperwork. What it does say, Special Instructions "Please go to veterinary.Com to look up disc disease." I am not able to pay for x-rays or labs. I took him to the ER [7/19] when he began yelping with every touch and movement and was shivering constantly. Whimpering started several weeks ago, progressed into yelps. He suffered a cracked rib when he was 5 weeks old and for about 2.5 years would yelp when he was picked up wrong (or was being separated from a favorite toy?) ER instructions: *Carry out on short leash walk or for bathroom Only *Cage rest *No running/jumping/climbing until recheck in 10 to 14 days. I am also following your strict rest guidelines. Thank you for your time. Darla and Gizmo
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Post by Romy & Frankie on Jul 24, 2021 13:31:02 GMT -7
Since the ER doctor did call it a possible disc neck issue, you are doing the very best thing by keeping Gizmo strictly crated. It is the immobility enforced by crate rest that helps the disc to heal. We always compare crate rest to treatment of a broken arm. The broken arm is immobilized in a cast allowing the two parts of the bone to knit together and heal. We cannot put a dog's spine in a cast so we use the crate to limit movement and thus allow the disc to heal. Discs take 8 weeks to heal and form secure scar tissue. If after the second visit to the ER vet, the diagnosis is something other than disc disease, you may not need the full 8 weeks. If the vet confirms a disc episode the full 8 weeks of crate rest are needed.
I am not sure if you have had a chance to look at the link Paula pointed you at. It has some good tips for setting up a comfy recovery suite: dodgerslist.com/2020/05/14/strict-rest-recovery-processThe signs of pain we look for are; ☐shivering, trembling ☐yelping when picked up or moved ☐reluctant to move much in crate such as shift positions or slow to move ☐tight tense tummy ☐can’t find a comfortable position ☐Arched back ☐ Holding front or back leg flamingo style not wanting to bear weight ☐head held high or nose to the ground ☐Not their normal perky selves? Full pain relief is expected in 1 hour and stays that way between doses. If pain is not in control, your vet needs to know asap to adjust meds.
I know that Gizmo is shivering. Some dogs shiver fairly frequently. If Gizmo is one of those dogs, look for another sign of pain to confirm. If Gizmo is currently showing two or more of the above signs of pain, he is in pain and the vet should be notified right away, so the pain meds can be adjusted.
X-rays may not be needed if the vet is confident it is disc disease. X-rays show only the bones of the vertebrae and not the discs between the vertebrae. Only if the disc has calcified will it be evident on plain x-rays. However, some dogs have IVDD and have no calcified discs or calcified discs not related to the current disc episode, while other dogs have calcified discs but no signs or symptoms of IVDD. Generally speaking, X-rays are used to rule out other problems mimicking IVDD. We have some information on calcified discs here:
All anti-inflammatories cause excess stomach acid which can lead to serious stomach damage. Since Gizmo has a sensitive stomach, it is particularly important that he be taking a stomach protector like Pepcid AC. Please speak to the vet as soon as possible about adding Pepcid AC to Gizmo's meds. It is the same product humans use and is available in any supermarket or drugstore
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jul 24, 2021 17:19:21 GMT -7
Darla, good information from Romy above--- be sure to read. Here are the extra things you can do at home to help with a neck disc: healhttps://dodgerslist.com/2020/05/05/cervical-care-tips/ It is important while on Galliprant to protect the stomach lining from too much acid. Call your mobile vet to early Monday morning to find out if Gizmo has an kidney, liver or a heart issue to keep him from taking the acid suppressor Pepcid AC (famotidine). If no health issues, purchase the less expensive brand X famotidine product at your grocery store. Brand name Pepcid AC® is more expensive. Find a product that is a 10mg pill. Gizmo will need to take 5mgs every 12 hours. Does the the gabapentin capsule you give 2x/day contain 100mgs? If not, how many mgs? Neck discs in addition to having pain signs of shivering, yelping typically also can have those listed below. Let us know if you are seeing any of these signs which means Gizmo needs your helping advocating to get pain meds adjusted to every 8 hrs (3x/day).
SIGNS OF PAIN: ⚙︎ shivering-trembling ⚙︎ yelping when picked up or moved, touched ⚙︎ 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
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Post by Darla & Gizmo on Jul 28, 2021 18:51:13 GMT -7
Thank you for all the valuable information. I'm so glad I found this board. Gizmo went to his follow-up today and the vet said 4 more weeks of crate rest. Also he also gave us 20 more doses of ✙ Galliprant. [Moderator's Note. Please do not edit 13.14 lbs 9.5 y.o. galliprant as of 7/19: 10mgs 1x/day for 14 days, then 8/2 test STOP for: _pain / _neuro as of 7/28 0.9mg/lb: 10 mgs 1x/day ✙for 20 more days, then 8/22 test STOP for _pain gabapentin 100mgs 2x/day traMADol 25mgs 3x/day diphenhydramine (generic for Benadryl) 12.5 mg needs GI tract protector, Pepcid AC, on board w/Galliprant! ]Vet said he would recommend surgery if Giz is not better in 4 weeks. I told him about this board and the conservative measures I'm taking; he was supportive. Darla & Gizmo
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jul 28, 2021 20:05:55 GMT -7
Oh dear, Darla, it appears you are not able to see the questions we have been asked asking about Gizmo. This makes us unable to give useful comments beneficial to Gizmo without facts from you. HELPFUL WRITING TIP: The most effective way to respond:
-- scroll down to the "QUICK REPLY" typing area. -- Avoid using the "Reply" or the "Quote" link.
QUICK REPLY allows scrolling up and down as you read then answer. Scroll up to a previous post and then back down to the "Quick Reply" typing area to continue your own post. EMAIL ALERTSTimely communications are needed when helping your dog. How set up a bookmark for your dog's thread for email alerts when you have received a reply: dodgerslist.boards.net/thread/7353/register-bookmark-dogs-post-threadDESKTOP MODE for Mobile DevicesThe Forum is best viewed via the "desk top view" of a mobile phone browser app (Safari, Chrome, Foxfire). Scroll down to the bottom of the screen to click on "Desktop". BELOW are the questions Romy and I have been asking you about Gizmo. Look forward to learning more about Gizmo with your answers to give our best help to you both. FYI #1: It takes 8 weeks for a disc to heal over and form good scar tissue. Short cutting STRICT rest, can disrupt the healing disc and cause Gizmo a lot of pain and perhaps loss of leg function, etc. Graduation day is 8 weeks from July 19: on Sep 13
FYI #2 : Vets don't RX Galliprant for 34 straight days. All meds have dangers to them. Prudent vets give a course such as 14 days, then stop to see if all pain is gone. That stop was to happen on 8/2. If no pain then no reason to be giving Galliprant. Help us understand more about why the vet gave you 20 more Galliprant doses (20 more days)?QUESTIONs (remember to scroll down to the end of the page to find the "QUICK REPLY" area for responding.) 1. Does Gizmo have other health issues, other diseases beside this disc episode that would explain the use of Galliprant? 2. Today have you see any signs of pain listed below? ☐ slow to move ☐ yelping ☐ shivering ☐ reluctant to turn head ☐ Looks with eyes rather than turn head to ☐ holds paw off the ground because it hurts to bear weight 3. Do you now have acid suppressor Pepcid AC® with only famotidine in it?4. Did gabapentin get adjusted so 100 mgs would be given every 8 hrs? Please let us know you are fully on board with getting Gizmo's disc healed. This page is a good way to educate yourself on the single most important part of care for Gizmo: dodgerslist.com/2020/05/14/strict-rest-recovery-process/
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Post by Darla & Gizmo on Jul 28, 2021 21:29:53 GMT -7
Can not find "Quick reply" I guess I'm having issues navigating. I'm going to open up on my tablet, see if that helps. Here we go. Looks like I was replying to old questions. Thanks for the tips.
Gizmo seemed to be getting better but 2 nights ago [7/27] when I went to pick him up, he tried leaping up to my shoulder; front paws draped over my shoulder with his body parallel against my torso. I know now that is not a healthy position for him. I've carried him like that since his was tiny...old habits die hard and we are working to change it. Anyway he yelped and it seemed was back to square one ie,shivering, whining, looking only with eyes, refusing food or eating very little.
Gizmos current meds: Gabapentin 100mg capsule x 2 daily (unchanged) after famotidine Tramadol 25mg every 8 hours (unchanged) ✙Galliprant 10mg every 24 hours, 20mg scored tabs broken in half (unchanged) There were 7 tabs to begin,14 doses plus todays 20 doses makes 34 daily doses total. Diphenhydramine 12.5mg prn (once a day or less) ✙Famotidine 2.5mg twice daily, before Gabapentin NEW started 7/27 These are 10mg tabs broken in 1/4
[Moderator's Note. Please do not edit ▲13.20 lbs 9.5 y.o. galliprant as of 7/19 20mg tab as of 7/19 Dr. L Rx: 10mgs 1x/day for 7 days, then 7/26 test STOP for: √7/27 relapse pain / _neuro as of 7/28 AS&V Dr. K. Rx: 10 mgs 1x/day for 20 days, then 8/18 test STOP for _pain 7/27 Relapsed disc gabapentin 100mgs 2x/day traMADol 25mgs 3x/day diphenhydramine (generic Benadryl®) 12.5 mg 1x/day ✙famotidine 2.5mgs 2x/day ]
Only other health issues are sensitive tummy when eating new food or treats, too rich and too oily foods cause diarrhea. Pollen allergy.
Thank you, Darla and Giz
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jul 29, 2021 8:06:28 GMT -7
Darla, thank you so much for the revealing information. Now things make more sense about your Vet's Galliprant Rx. I'm so sorry Gizmo had a relapse. It is a challenge to think one step ahead of our little furry friends. They don't understand their disease and the need to follow STRICT rest principals and back horizontal to the ground as we humans do. What signs of pain do you observe today? Is pain today fully in control with no changes to his pain meds? If there are still any signs of pain, please phone in ASAP in and report which pain signs you see today and advocate for 1) gabapentin to be Rx'd for every 8 hrs. 2) traMADol to be increased to the max analgesic dose for 13lbs (5.96 kg) dog The usual in controlling pain is to Rx at the higher end of the mg range AND promptly every 8 hours. 5.96 kg dog X 10mgs traMADol = 60mgs dose 3x/day Most vets would round down to a full 50mgs tramadol tab 3x/day Gizmo does not need another problem of GI tract damage on top of this disc relapse. Discuss if the usual dose of famotidine to suppress stomach acids can be taken by Gizmo. 13.46 lbs X 0.44mgs famotidine = 5.9 mgs famotidine 2x/day Most vets would round down to 5mgs 2x/day
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Post by Darla & Gizmo on Jul 29, 2021 14:37:44 GMT -7
Today Gizmo is using only eyes [pain] to look up at me and didn't eat [pain] till 12:30 pm. He is whimpering off and on [pain]. So far no yelping.
I will contact vet regarding meds.
I requested detailed summary of visit; it should be in my email today.
Thank you, Darla and Gizmo
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Post by Romy & Frankie on Jul 29, 2021 14:50:23 GMT -7
I am sorry that Gizmo is in pain again.
Please let us know what changes the vet makes in Gizmo's pain meds.
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Post by Darla & Gizmo on Jul 30, 2021 17:53:34 GMT -7
AS&V Dr. K. DVM via phone increased ▲traMADol [7/30] today from 1/2 of 50mg tab to 3/4 of 50 mg tab x 3 daily. All other meds stay the same.
[Moderator's Note. Please do not edit 13.14 lbs 9.5 y.o. galliprant as of 7/19 ER Dr. L Rx:: 10mgs 1x/day for 7 days, NEGATED with rebased disc: √7/27 relapse pain / _neuro as of 7/28 AS &V Dr. K. Rx: : 10 mgs 1x/day for 20 days, then 8/18 test STOP for _pain 7/27 Relapsed disc, dog leaped to owner shoulders gabapentin 100mgs 2x/day traMADol ▲37.5 mgs 3x/day AS &V Dr. K. Rx on 7/30 diphenhydramine (generic Benadryl®) 12.5 mg 1x/day famotidine 2.5mgs 2x/day ]
No yelping today [7/30]. Seems to be moving easier but still not moving head, only eyes [PAIN!].
I am waiting for an hour after pain meds to give him meals, he's eating better now. I am giving him his meds with his favorite treats so he'll have something on his tummy.
Thanks you, Darla and Gizmo
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jul 30, 2021 19:42:04 GMT -7
Darla, you are still reporting quite some considerable pain with Gizmo not wanting to move his head, looking only by moving his eyes. He should not be left to suffer in this way. Be sure you get a phone call in early Sat morning to get his meds adjusted. (see below for the details) Here is likely the pain world Gizmo lives in now. Explained by an specialist in pain management. Dr. Petty, DVM, CVPP, CVMA, CAAPM, CCRT is a past president of the International Veterinary Academy of Pain Management and is a frequent lecturer at local, state and national conventions. Did you ask about gabapentin methocarbamol and famotidine?
What was the reason your vet (Mobile vet?) give for not adjusting gabapentin to 3x/day, and why no methocarbamol to deal with neck muscle pain Gizmo is still suffering with? In the past, I found I've forgotten to get all my questions answered at the vet. So I now make a list to check off and now all my questions get an answer. Hope this idea will help you and Gizmo too. 1) On Sat. morn what can you do to call and strongly advocate for gabapentin to also be every 8 hrs. Gabapentin only lasts in the body for about 8 hrs, leaving Gizmo in pain for a couple of hours with every 12 hrs (2x/day). 2) Ditto for getting a muscle spasm med on board METHOCARBAMOL every 8 hrs so he can turn his head without pain and eat without chewing discomfort too.
3) Question if the usual dose of famotidine to suppress stomach acids can be taken by Gizmo. Pain causes extra acids, Galliprant causes extra acids. Gizmo does not need bleeding ulcers to happen on top of dealing with uncontrolled pain and the disc episode. 13.46 lbs X 0.44mgs famotidine = 5.9 mgs famotidine 2x/day Most vets would round down to Famotidine 5mgs 2x/day Will be watching for an update from you Saturday and being successful in getting the help Gizmo needs to get pain fully in control dose to dose and round the clock.
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Post by Darla & Gizmo on Jul 31, 2021 20:05:06 GMT -7
Today Gizmo seems to be moving his head a little more but looks awkward in doing so. He has major separation anxiety yesterday and today where there only used to be periodic episodes before. He pants and shivers severely as dogs do when very frightened, fireworks etc. He has eaten all meals since yesterday afternoon BUT it's mostly the soft homemade portion; only eating a few kibble from the 1/4 cup I give him. When I last spoke with him [AS&V Dr. K 7/30], I told him about Gizmo only looking with eyes, shivering and whimpering. I asked about increasing Gabapentin, he said he was not comfortable with that yet. I asked if there were other meds to help him relax, he said he was only going to increase Tramadol and wait and see. He has told me 2 or 3 times that Giz will probably need surgery and wants him to see a neurologist. I'm a bit skeptical and concerned. Vet [AS&V Dr. K] sent me on [7/30] case notes from [7/28] visit. Would you be interested in viewing it? i.postimg.cc/SQ5N6zgK/Darla-Gizmo-7-28-2121-appt-notes.jpg Transcription:
(I did not receive these until about 2 days later: Patient History Report Client: Warner, Darla (1995) Patient: Gizmo (2941) Phone: ×××××××××× Species: Canine Breed: Dachshund Address: ×××××××××× Age: 9 Yrs. 6 Mos. Sex: Male Everett, WA 98203 Color: Red Date Type Staff History 7/28/2021 P SK 10.00 [None] of Galliprant 20mg (1855) Rx #: 1169 Exp. Jan 28/2022 0 Of 0 Refills Filled by: SK Give 0.5 tablet by mouth (after food) every 24 hours 7/28/2021 TC LS a few months ago Gizmo started yelping more often. - TENTATIVE a few months ago Gizmo started yelping more often. Back seemed to be bothering him more frequently. Yesterday O pet dog and dog became more irritated than before Dr.K reccomends more cage rest at 4 weeks at least, keep activities as low as possible Diamond vet Dr. longoni prescribed Tramadol 50mg, O gave 1/2 tablet by mouth every 8-12 hours as needed, Galliprant 20mg gave 1/2 tablet by mouth once a day, and gabapentin 100mg gave 1 capsule by mouth twice a day O gave pepcid AC 2.5mg 2 times a day and Benadryl 12.5mg every day or 2, self prescribed PE: No obvious pain, on back, Proprioceptive reflex intact Discussed X-ray : O couldn't afford Discussed referral to neurologist ; Pending approval from owner RX: Send home Galliprant 0.9mg/lb q24 hours for 20 more day O to continue cage rest Contact Neurologist ASAP if condition progress 7/28/2021 V LS Jul 28, 2021 02:38 PM Staff: LS ------------------------------ Weight : 13.20 pounds 7/28/2021 CK SK Exam after cage rest from Disc disease, No pain, No paralysis Reason for Visit: Exam Medical Date Patient Checked Out: Jul 28/2021 Practice 1 7/28/2021 V SK Jul 28, 2021 02:17 PM Staff: SK ------------------------------ Weight : 4.00 pounds B:Billing, C:Med note, CB:Call back, CK:Check-in, CM:Communications, D:Diagnosis, DH:Declined to history, E:Examination, ES:Estimates, I:Departing instr, L:Lab result, M:Image cases, P:Prescription, PA:PVL Accepted, PB:problems, PP:PVL Performed, PR:PVL Recommended, R:Correspondence, T:Images, TC:Tentative medl note, V:Vital signs Animal Surgery and Vaccinating Page 1 of 2 Date: 7/30/2021 10:59 AM ----- END transcription---- I recently learned our mobile vet is not full service, only vaccs, microchips and a complimentary exam. So I took him to a new vet [AS&V Dr. K on 7/28]one who had good reviews and was recommended by a friend. There low exam fee was also a factor. I am now giving Gizmo 5mg ▲ Famotidine 2x daily after asking vet [AS&V Dr. K]. [Moderator's Note. Please do not edit 13.20 lbs 9.5 y.o. galliprant as of 7/19 20mg tab: 10mgs 1x/day for 7 days, NEGATED with √7/27 relapse pain / _neuro as of 7/28: 10 mgs 1x/day for 20 days, then 8/18 test STOP for _pain 7/27 Relapsed disc; dog leaped to owner shoulders gabapentin 100mgs 2x/day traMADol 37.5 mgs 3x/day diphenhydramine (generic Benadryl®) 12.5 mg 1x/day famotidine ▲5mgs 2x/day ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jul 31, 2021 20:26:26 GMT -7
Darla, excellent job of advocating for famotidine 2x/day! Good work!
Case notes are from Dr. Mobile Vet? They would likely explain to us many things that are a mystery. The notes are from the mobile vet? Thank you! Will be watching for them.
Are you soaking the kibble in 1/4 cup water (or a meat broth) that goes in his homemade? What is the homemade meal made of? Has he always had this homemade or something new since the neck disc?
I'm glad you have a new vet. What date did you go to the vet with Gizmo? Dr. New Vet will now be Gizmo's only vet he sees for this disc episode and other things?
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Post by Darla & Gizmo on Jul 31, 2021 20:47:47 GMT -7
Case notes are not from the new vet since mobile vet was not full service <<- their words.
Homemade made dog food is 60% chicken and egg, 20% white rice and 20% vegies and fruit; carrots, apple, green beans, blueberry. I have been making his food for about 7 years due to 1. Wanting to know exactly what goes in it 2. Cost. I give small amount of kibble with it for his dental hygiene.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jul 31, 2021 21:03:43 GMT -7
QUESTIONS Are you soaking the kibble in 1/4 cup water (or a meat broth) that goes in his homemade?
What date did you go to the vet with Gizmo?
Use the "Quick Reply" area to write in at the bottom of this thread. Quick Reply allow you to scroll upward to look at all the questions asked and then back down to answer.
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Post by Darla & Gizmo on Jul 31, 2021 22:34:05 GMT -7
I do not soak unless dry kibble is the only food for him at the moment. Usually only give a small hand full. If dry kibble is the only thing for that meal then I give him much more and soak it in broth from his homemade food that I have frozen...yes, my world revolves around this little dude.
I think visit was yesterday.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 1, 2021 6:57:59 GMT -7
There is reason for soaking the kibble with a neck disc dog. Crunching or chewing may be painful with a neck disc. Please give it a try to soak the kibble in some yummy meat broth to see if that helps him to eat all his kibble. BROTH: Boil up a hamburger patty. Cool, discard the fat disc at the top. Soak kibble in an equal part broth to soften it (1/4 cup broth to 1/4 cup kibble). Crumble 1-2 teaspoons of beef meat on top of his meals for extra yumminess. It is essential that Gizmo be eating that 1/4 cup kibble. Kibble is formulated to include vitamins and minerals that a dog needs. Your description of home cooked may have some of the vitamins and mineralsl but not all of them. TIP: Brushing teeth is the only real way for dental hygiene til a cleaning. Brushing removes potential plaque build up from around a tooth, not the eating of crunchy kibble which can get caught in-between the teeth!
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Post by Darla & Gizmo on Aug 1, 2021 7:55:33 GMT -7
Thank you Paula, I so appreciate the wisdom and knowledge you're sharing.
Have you had a chance to look over the vets notes? I think there's a section that says, "No pain" I don't understand this.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Aug 1, 2021 9:39:22 GMT -7
Looks like when vet examined the back on 7/28 there were no obvious signs of pain there. And the paws did not knuckle under. Darla reports on 7/30 pm: still not moving head, only eyes With a neck disc, avoiding moving the head, looking by moving eyes rather than head is a sign of pain. 1) Did you you specifically report to the vet your observation about neck movement at the 7/28 visit? 2) What time were pain meds given 7/28 am before the vet appt later that day? 3) Did the evening pain on 7/30 occur 8 hrs after last gabapentin and traMADol ( 7/30 Rx via phone by Dr. K) doses? Was the pain nearing the time for next doses of the two pain meds?
gabapentin lasts in the body only for about 12 hours. methocarbamol addresses a very typical kind of pain with neck discs— muscle spasm pain. Are you keeping a med chart so you, can see patterns? A medication chart is useful to see patterns, have dates and specific facts handy as you discuss things with the vet. D/l a sample and a blank form to use with your dog's meds dodgerslist.com/wp-content/uploads/2020/02/med-chart-printable.pdfAs always when you post, we like to know the status of neck pain. Is today, Sunday, 8/1 still improving ability to move head (no more just moving eyes to see left or right?) because pain is now fully in control right up to the next dose of 2 pain meds? gabapentin 100mgs 2x/day traMADol 37.5 mgs 3x/day
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Post by Darla & Gizmo on Aug 1, 2021 15:15:11 GMT -7
I do not understand the vet noting no obvious pain! It's obvious to me. And actually the vet said he was concerned that there was not significant improvement since his er visit.
Gizmo would have had his pain meds about 7:30 on the morning of July 28 appointment.
I can't remember the pain in relation to Gabapentin dose. I will see if I can get the med chart printed to have clear documentation.
Gizmo seems to be moving his head a little more. Seems a little more relaxed.
Still giving Gabapentin 100mg x2 daily, Tramadol 37.5mg x3 daily and Galliprant 10mg once daily.
I have upgraded his recovery suite to a lg wire one that has room for both food and water dishes. I am only taking him out 3 times a day instead of 4 to 5.
He has to get better... It's the only option.
D&G
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Aug 1, 2021 17:16:59 GMT -7
Darla, the word "improvement" always needs to have adjectives. There are four kinds of improvement so have no idea what was being referred to. -- nerve damage improvement can take months. You report no nerve damage. -- pain improvement happens in one hour with the correct combo of pain meds. -- painfully inflamed cord tissue can take 7 to 30 days on an anti-inflammatory drug. -- disc improvement takes 8 weeks for the scar tissue on the exterior of the disc to form. Since the 7/19 ER visit, Gizmo had a relapse to his disc on 7/27. Did you tell Dr. K about the leap?
The only remark in the 7/28 Case Notes was appt was for "back seemed to be bothering him more frequently. You reported 7/28 petting Gizmo caused more irritation A relapse means, a set back in pain, restart the count for 8 weeks STRICT rest and restart the 7-30 days it might take Galliprant to resolve all swelling. If Dr. K was not told about the excessive movement to the spine with that leap to your shoulders and and being very painful, Dr.K was missing the real reason you got an appt with him. He was unaware of the leap to your shoulder and the set back to the healing disc. That would make sense if he was not pleased the inflamed and painful neck was not "improving" with Galliprant. As of 7/28 Dr. K. Rx'd a 20-day course Galliprant. It looks like to me here we have all the important details now and a good picture of what is going on with Gizmo. The past is gone and we've learned some things. The more we know the better we can do in the present. So the focus from how on is in the present. What can we do to help Gizmo heal his disc, get the painful inflamed cord resolved. -- I'm pleased to hear of pain improvement. It is slowly happening since the 7/30 via phone traMADol adjustment by Dr. K. Hoever, Dodgerslist aligns with vets who know IVDD pain with not waiting to see how tramadol works. But instead using an aggressive pain medadjustment approach that assumes a painful disease IS painful. And to take into account what owner says about about neck pain observations. But then Dr. K appears to have not gotten the whole story about the relapse and the restart of everything. -- Tell us more about the new recovery suite. 1) is suite only large enough to easily turn around in, and when lying down to fully stretch out the legs? If not, have you padded out any extra floor space with rolled up blankets? Gizmo may even like to rest his head on one of the rolled up blankets. 2) are water bowls attached at head height to the side?
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Post by Darla & Gizmo on Aug 1, 2021 20:31:27 GMT -7
I was sure I told him about the incident but after reading your info, maybe not. -sigh-
Recovery suite may have to be altered. The old one is a med dize plastic transport one. From the info above I see that it was a perfect size but so dark with little barred windows and door.
New one is a large wire kennel with plastic tray liner. I used parts of another kennel to lower the ceiling since he was able to jump up. I've secured a blanket in a corner, cave style so it's cozy but not weighing him down. At some point early in crate rest I could see that he was struggling with weight of blanket. He chooses to bury himself in covers. There is a thick fleece type blanket folded up for a mattress and then a smaller light one that he gets under or lays on. He has a stuffy that he uses as a pillow.
Gizmo is an athlete and dare devil so he must have a roof.
Since I am able to put food and water dishes in new one, I don't need to have him come out as often.
I have the kennel up on my very firm bed, does not bounce or wiggle.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 1, 2021 21:12:15 GMT -7
Yes, by all means, eating and drinking take place in the recovery suite to limit movement of the spine.
Gizmo should be much happier in a wire suite! Just pad out the extra room with rolled up blanket. Good job in lowering the ceiling. Are food and water attached at head height to the new wire suite?
How to insert a JPGs in a post for computers, iPads, but not all mobile devices
Instead of writing in the "Quick Reply" space at the bottom of the page, look to the right of that space for a "REPLY" button. That will take you to composing with all the enhancement features available including a button to "ADD IMAGE to POST" button.
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Post by Darla & Gizmo on Aug 1, 2021 23:48:10 GMT -7
Food and water are elevated to shoulder height. Thanks for the photo tip.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 2, 2021 10:39:22 GMT -7
Darla, there is way too much space. Should only be large enough to easily turn around. And when lying down that all four legs could be fully extended. Make a divider to reduce the space. 1) FREE idea: do you have a large piece of cardboard that fits the dimensions of the narrow side of the crate? Then punch holes along each side vertical side. Use tie wraps to secure cardboard to crate wires. i.postimg.cc/qR6JfWxS/cardboard-divider.jpg 2) Hardware stores will cut plexiglass down to dimensions you need for a divider. More expensive option but have tried it out with a friends rambunctious dogs and they could not destroy it.
3) If you have any more left of the kennel you dismantled, perhaps the wire grid or another part could fashioned into a divider.
Attached bowls to the side of the crate. You would have do use different bowls. -- look for cottage cheese container size. At my grocery store deli they have the right size containers and they are clear. One container gets tie wrapped to the side of crate. Another container inserts into holder for the food or water for easy washing, refilling, etc.
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Post by Darla & Gizmo on Aug 2, 2021 16:43:46 GMT -7
I actually have clear shallow containers from deli and some zip ties. Will set it up once I figure out how to decrease space in kennel. Rolled up blankets and cardboard will be pulled down, pulled apart then layed on. That is why I have only one smaller blanket that is loose. At his next potty time, I will secure him in the other crate while I rework this one. Thank you Paula. D&G I added a back wall and lowered the ceiling about 5 more inches. I also stuck a comforter behind the back wall for added security. He has a small water dish mounted on the side which I can easily remove for cleaning.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 2, 2021 17:05:36 GMT -7
Darla, it looks to be the right size now. After enlarging picture, I see the slant back wall from another crate or something. Very clever conversion to a smaller area. Having the bowl attached to the side makes it possible to tighten up the area. Good job. And good job in adding a JPG!
What do you observe about his neck movements today?
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Post by Darla & Gizmo on Aug 2, 2021 18:13:53 GMT -7
Yes, picked up crate yesterday through Fb Buy Nothing. There were 3 extra parts of various sizes. Existing hooks and zip ties made it fairly easy.
Gizmo seems to be moving head about same or maybe a tiny bit better.
He's eating all meals and has normal potty habits. Usually he easily burrows under blanket when he's ready to sleep. Today he only pawed at blanket then lay down on it. With the breeze from window, this is not normal for him.
I can't see any other signs of pain and there has been no yelping or whimpering.
I worry (too much) that he gets depressed being in the kennel 24/7.
I've decreased meal size and increased from 2 to 3 times..trying to give him relief from boredom.
What do you think? Any other ideas?
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