|
|
Post by Emily Hinkebein on Jun 27, 2022 13:31:09 GMT -7
i.postimg.cc/HndzvQRF/dox.jpg i.postimg.cc/J43ZF2Nx/Conserv-NECK.png☆ 1 currently pain? ☐ Slow, ginger movements when first coming out of crate to go to the bathroom☐ yelping when picked up or moved - haven't tried to pick him up since we took him to emergency vet ☐ he slept/didn't want to move the first 24 hours back from the vet, now that the meds are in full force and he's rested, he doesn't want to be still or maybe just doesnt like being stuck in his crate ☐ he sometimes walks gingerly on back legs. when sitting he sometimes has back left leg lifted☐He is a pretty tame guy and loves his naps. before the injury he would get a burst of energy and play in the evenings. Haven't seen that but he's been crated. He's been sad and whining to get out the past 24 hours. 2 17lbs and is 5 years old 8AM: 25 mg Carprofen & 100mg Gabapentin (he's been on Carprofen for a couple weeks) 4pm: 100mg Gabapentin & 25mg Amantadine Midnight: 100mg Gabapentin [MED LIST/HISTORY- Moderator's Note. Please do not edit
17lbs 5 y.0
carprofen as of 6/25: 25mgs 1x/day for 29 days, 7/24 test STOP for: _pain / _neuro
gabapentin 100 mgs 3x/day
amantadine 25mgs 1x/day
Boone needs GI tract protector, Pepcid AC, on board w/carprofen! ] The usual dose of Pepcid AC (famotidine) for dogs is 0.44mg per pound. --Give 30 mins before the anti-inflammatory. --Dose thereafter every 12 hours for as long as your dog is on the anti-inflammatory.  ** ] C.. PEPCID AC: Does my dog have any health issues to prevent use of Pepcid AC (famotidine)? Not that I know of. ☆ 3 -- stomach damage. NONE☆ 4 Dachshund named Boone. My name is Emily ☆ 5 Neck disc related injury. Vet is referring us to a neurologist who is supposed to call to schedule a consult. -- DVM? Yes - was emerngency vet because it was a Saturday, not our regular vet -- specialist surgeon Getting referral☆ 6 What was the date you saw the vet for CONSERVATIVE treatment? Went to emergency clinic on 6/25 after I could not touch him without him screaming/yelping☆ 7 He is able to go to the bathroom with no issues ☆ 8 He can walk which is good but makes it hard to keep him still. He walks gingerly on back legs at times and I notice his back legs twitch while he rests.
|
|
PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
Member is Online
|
Post by PaulaM on Jun 27, 2022 14:46:43 GMT -7
Welcome Emily! Still getting a sense of where Boone is... a few questions:
What date did you begin STRICT rest inside of a recovery suite (wire crate, 8 panel ex-pen, Baby's PAC N PLAY?1) What date did Carprofen start that was about 2 weeks ago? 2) What was the reason it was prescribed?3) For how many days did the ER Vet prescribe carprofen for?4) Which kind of vet diagnosed a disc in the neck (your local DVM vet or the ER DVM vet?7) What is the reason to seek a neuro consult when pain appears to be pretty much in control (maybe needs some adjustments to meds) and you are not reporting any neuro loss?6) What other signs of pain do you notice currently that indicate a neck disc?
➕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 standing weight
If you ARE seeing signs of pain when having to move or nearing the next dose of pain meds be aware of these things: --- Pain meds last about 8 hrs. Good to see gabapentin is every 8 hrs. --- " Amantadine alone is not an effective analgesic but..." Read to understand how Amantinine could affect pain control: marvistavet.com/amantadine.pml--- It typically will take 3 different pain meds each working on a different kind of pain during a disc episode. ---Gabapentin is for nerve pain. Amantadine may be working in conjunction with this med. --- Methocarbamol. Very typical to a neck disc is muscle contraction pain. If you are seeing signs of pain advocate for methocarbamol 3x/day --- traMADol deals with overall pain. Advocate for 3x/day if you are observing any signs of pain. NECK DISK CARE No need to reinvent the wheel with at home nursing care during a disc episode. ◽️Lots of member tips to help limited movement time for disc healing go smoother: dodgerslist.com/2020/05/14/strict-rest-recovery-process/ ◽️Extras you can do at home to help with a cervical 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/PEPCID AC (famotidine)
Learn the 3 reasons why to verify Boone has NO health issues to prevent Pepcid AC. If no health problems, then get at the grocery store to protect his stomach: dodgerslist.com/2020/05/06/stomach-protection/Let us know the date of any neuro diminishment in the back legs OR the front legs: 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 of the damage. 1. 6/13 or 6/25? Pain caused by the intial disc tear & inflammation ar0und 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 conservative treatment or with a surgery. 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.
A quick overview of conservative treatment vs. a surgery:
dodgerslist.com/2020/02/10/surgery-vs-conservative/
|
|
|
|
Post by Emily & Boone on Jun 27, 2022 15:59:03 GMT -7
[Duplicate quoted words of others removed
Please do not edit this page as it is being marked. Add any corrections or additional info in a new post. Thanks! ]
Hello - I did register but I'm not sure how to link my account with this post.
We began [Strict rest] this on 6/25 at 5pm.
1) Sorry, I was incorrect. Carprofen was prescribed about 3 weeks ago on 6/6 until 6/15 when we ran out. We got a refill on 6/20.
2) [reason Rx'd 6/6] He started limping after running the fence with the neighbor dogs. We took him to his usual vet (not ER vet), they did x-rays and an exam and could not find anything. They stated it was likely a pulled muscle or muscle related and prescribed carprofen. He was back to his usual self again but a couple days after we ran out of meds he started limping again, some whining. We called the vet and they gave us more carprofen on 6/20.
He was better again until the morning of 6/25 a switch flipped. I couldn't move him or touch him anywhere without screaming. Even reaching for him but not touching him, he would cry out like he was anticipating pain. So I am not sure if these are separate injuries or related. I am not sure what happened on 6/25 that triggered the more extreme pain.
3) The ER vet did not prescribe the carprofen, but recommended continuing its use [for how many days?] along with the gabapentin and amantadine that he prescribed. He did recommend not refilling the carprofen because extended use is not good for kidneys? if I remember correctly.
4) The ER DVM vet diagnosed the [neck] disc in the neck. He said he could tell there was neck pain due to the way he was holding his head and moving. When he was examining his neck, Boone bit at him, which he has never ever bit or been aggressive with someone.
7) The ER DVM vet said he would send our info to the neurologist who would determine whether rest & pain management or surgery would be needed. At that moment, it made sense because he was in so much pain and we were scared. Now that we are home and settled with meds and he is able to walk, I'm sure surgery would not be the recommended route.
6)Before meds, he would look with his eyes instead of turning his head, difficulty turning around in small spaces, tenderness around head area. Day 1 a couple hours after meds, he's still had some tenderness. I was very lightly petting his head and he yelped a bit.
Of course I do not want him to be in pain.. but I worry now that the meds have kicked in and he is feeling better that he won't be as cautious. He has been rubbing his nose into the blanket, stretching, rolling (in his crate)
I should probably mention we discovered last year that he has calcified discs.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
Member is Online
|
Post by PaulaM on Jun 27, 2022 16:53:24 GMT -7
Emily, thank you for registering. Do bookmark in your browser so you can always easily return here: dodgerslist.boards.net/thread/8664/The single most important care with a disc is the limited movement so secure disc scar tissue can form. Vet visits should be limited to only the most urgent of things. Most things such as med adjustments can be handled over the phone. This eliminate a risky vehicle transport in and handling inside the clinic/hospital. Neck discs just can be more difficult to heal. When any part of the body moves, most always the head/neck will move also. That makes them more painful. Always a need to never have any patience with pain. Phone the vet is you are seeing any signs of pain to get meds adjusted as mentioned in my previous post. It can take carprofen about 7 to 30 days to get all the painfully inflamed tissue around the cord gone. Til then it is the pain meds that provide full, round the clock comfort. No one wants a dog on any of the anti-inflammatory drugs including carprofen one bit longer than all the benefit having been achieved. That is all pain is gone. Please bone up on how an anti-inflammatory is used during a disc episode so you feel confident in asking pertinent questions and relating any concerns you may have to the vet. dodgerslist.com/2020/04/18/steroids-vs-nsaids/We want to know for how many days is carprofen to be used as of 6/25 when you got the last refill.
Crate rest started on 6/25. Any carprofen previous to 6/25 was negated for a disc episode. Carprofen as of 6/25: 25mgs 1x/day for ? days, then STOP test for: _ pain/_neuro diminishment
We track days since 6/25 on carprofen. Often the course of carprofen will be a 7 or a 14 day course. Then a stop to see if all pain is gone. Naturally, the pain meds that deny you seeing pain, would also be stopped. If pain surfaces then another course, another stop to see if pain. All because no one wants to be using an anti-inflammatory past the point of the benefit. Fingers crossed with good crate rest principals and at the end of this course of carprofen all swelling will be gone. Rule of thumb on STOP of carprofen pain = swelling = back carprofen, pain meds and Pepcid AC
POTTY TIME Are you carrying him to and from the potty place? You stand in one spot. The 6' leash allows him only a bare minimal amt of footsteps to take care of business. Alternate is use of a 6' diameter ex-pen as the fence around the potty place. The physical and visual lets Boone know there will be no sniff festing going on! dodgerslist.com/wp-content/uploads/2020/04/Potty-leash-harness400-19kb.jpg **We look forward to reading on only the words you write. Using QUICK REPLY means no need to quote us. You can scroll up and then back down to QUICK REPLY at the bottom of the page continue your post. Write a full sentence. Include if needed 1-2 words of reference to orient us.
Boone has a really good chance to properly heal his disc under conservative treatment with strict rest. Mark your calendar for his graduation day on Aug 20. |
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
Member is Online
|
Post by PaulaM on Jun 27, 2022 16:57:55 GMT -7
EMAIL Alerts Your can receive email alerts when someone has posted. Timely interaction/communications is needed when helping your dog. i.postimg.cc/T1xztZX3/Bookmark.png ** Bookmark your dog's thread to receive an email alert when someone has replied. Go to the CONSERVATIVE Board dodgerslist.boards.net/board/6/conservative 1. Look for your dog's thread and checkmark it. 2. Look for the white ACTIONS button towards top. 3. Select “Notification Options" from the pull down menu — check mark “NEW POST” change from never to INSTANT email — press the SAVE button. Click the “x” to close the window 4. Next choose the “Bookmark” See the tiny book symbol now! i.postimg.cc/GhKYTNg7/Bookmarking.jpg |
|
|
|
Post by Emily & Boone on Jun 30, 2022 9:29:42 GMT -7
I have 23 [carpofen] pills left after this morning's dose, so I had 29 doses left on 6/25 including the dose I gave him that morning.
We do have the ✙Pepcid AC in use now.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
17lbs 5 y.0
carprofen as of 6/25: 25mgs 1x/day for 29 days, 7/24 test STOP for: _pain / _neuro
gabapentin 100 mgs 3x/day
amantadine 25mgs 1x/day
✙Pepcid AC ?mg ?x/day ]
We have his recovery suite right next to the back door and have been going out the back a couple steps to the yard and then giving him that 6 foot space. We have not been carrying him as we thought picking him up would do more harm that him walking. We did have an episode last night where he did not want to get up to go out and cried out when we tried picking him up. We got him outside and he immediately peed but then plopped down and didn't want to move. I emailed the ER vet about adjusting meds or adding tramadol and this was his response "Tramadol is not thought to be very effective in veterinary patients as it relates to pain control. I am happy to fill as prescription for it with an understanding that its efficacy is questionable, and it is not thought to provide veterinary patients with much pain relief. Please let me know on if you would like a prescription for tramadol."
I'm a little annoyed that he did not provide an alternative or try to brainstorm other options with me if he doesn't think Tramadol would be the right route. My fiancé's family dog also had a slipped disc was on tramadol, and they said it seemed to work well. I am calling his usual vet today to see if they can provide a medication plan without having to bring him in.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
Member is Online
|
Post by PaulaM on Jun 30, 2022 10:40:14 GMT -7
Emily, hope to hear exact details of any med changes (mgs, x/day) that gets Boone in full comfort from pain as it should have been on 6/25. What are the exact details of Pepcid AC now on board: ?mg ?x/daytraMADol CONTROVERY Several studies have looked tramadol after its absorption into the body, and it seems that each dog's or even breed’s metabolism of the drug is different. Therefore, the best way to determine whether your dog's dosage is appropriate is by observing your dog while you're home. For many dogs on this Forum prescribed a typical 3-way cocktail of pain meds (gabapentin, traMADol and methocarbamol) PROMPTLY every 8 hrs, they ARE then in full comfort from pain. Let's hope your Boone will also then be in full comfort. If not alert the vet to change out a med, up the dose, the frequency till the correct adjustments fit Boone's needs perfectly.traMADol READING REFERENCES :If you can't safely carry 17 lbs Boone to and from his suite out to potty, then we have other ideas. Let us know.
Once pain is in full control round the clock, then you will be able to care for him without causing him pain.
LIFT and CARRY (support both ends, keep back horizontal to the ground). Web article: dodgerslist.com/2020/05/20/back-support/ADVOCATE for a shorter course of Carprofen. The usual is a 7-day or a 14-day course , THEN STOP to find out if carprofen has done its job. No one wants a dog on carprofen when there is nothing left for it to do! Vets who know IVDD do not issue a 29-day course of carprofen. They do a course, test STOP to see if another course is needed. Essential reading so you can speak up on behalf of Boone on the use of Carprofen with a disc episode: dodgerslist.com/2020/04/18/steroids-vs-nsaids/
|
|
