PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 15, 2022 16:46:32 GMT -7
Barb, I look forward to your posting to include dates, details of names of meds, dose in mgs, how often, date started. Oh I now see he is not at home. Correction, he IS at home. Daily trips into vet for meds, etc.
After reading and getting to the end where there is vet noted improvement, give Ollie a chance to recover. At this point feed him anything he would like just to get him started eating again: smelly yummy stuff: liverwurst, cheese, turkey meat.
At home is he on any meds or still getting his meds at the clinic?
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Post by Barb & Ollie on Jul 15, 2022 20:39:26 GMT -7
Ollie: 14 yrs 2 mos. Approx 14 lbs. I should clarify that Ollie’s issues started on Monday July 11th. (He was treated by our vet at the clinic [7/12-7/15]from 8:30-5:30 Tues-Fri. We brought him home each night. I called the vet due to his wobbly walk, noted right leg swaying in. Was given gabapetin 100mg, once daily. I gave the dose with food. A short while later he started escalating with panting and acting like he was going to vomit. I called the office, worried it was too high of a dose and was reassured it wasn’t. He continued to decline-not eating or drinking. I brought him to the vet on Tuesday (7/12). When I picked him up that evening the dr thought it was a disc issue and said he was dehydrated. He gave him IV fluids, X-rays, a [name of?] steroid shot and something for pain. He r an labs. When we got him home Ollie wasn’t getting better. The following day (7/13) the doctor said labs showed he had pancreatitis and that it’s very painful. He said he believes that was the bigger issue than the disc, as Ollie was still able to walk. Was given prednisoline 5mg to be given twice a day for 3 days, the start to decrease doses. Not easy giving a dog a pill that won’t eat!! When we picked him up on Thursday 7/14, doctor said he gave him decadron [Dexamethasone] and to hold off on giving him the prednisolone. Thursday night was the first time we saw improvement-he didn’t seem to be in pain. But, still seemed out of it. [MED LIST/HISTORY- Moderator's Note. Please do not edit
14lbs 14 y.o.
Local DVM vet on 7/12
crated 7/12
7/15 currently at home w/daily trip to vet for IVDD meds, pancreatitis treatment: IV fluids.
name of steroid shot 7/12, able to wobbly walk
prednisolone as of 7/13: 5mgs 2x/day for 2 days;
decadron [Dex] on 7/14 pills or a shot?
gabapentin 100mgs 1x/day
Ollie needs GI tract protector, Pepcid AC, on board w/prednisone, Dexadron! ] Today (7/15) we dropped him off again. Each day my husband and I struggled with ‘how much more can this dog go through?’ I told the doctor I would be thrilled if Ollie recovers, but his quality of life has priority. When my husband picked him up, the doctor told him all of Ollie’s labs have improved. He sent a copy to show the change since Wednesday. He just needs to eat now. He slept for 2 hrs after he got home tonight. I forced some mushy food into his mouth-maybe a teaspoon worth. An hour later, I had a glop of food in my hand and when I reached for a napkin, he started licking the food up out of my hand! He is still tired, but seems much more alert now too. He is giving us eye contact now. We take him to vet tomorrow again. Not sure what the plan is next, but what a difference a few hours have made! It has been a long week with mostly emotional lows. I’m so relieved to see him doing so much better. We have taken Ollie to the same vet for the past 9 years, since we relocated to this area. He is not really old, but he is old-school. No credit cards, no computer! If we get past the pancreatitis, what meds do you recommend for his disc issue? Is prednisolone appropriate? We have had adequan injections done in the past for minor flare-ups and he has responded well to those. He is no longer hunched over like he was a few days ago. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 16, 2022 9:36:38 GMT -7
Barb, thanks for the extra info that helps us to put all the pieces of the puzzle together in the right order. And so wonderful to hear Ollie is turning the corner in his healing and starting to eat again, also not in pain! PancreatitisQuickly reading some about this disease. Dietary fat causes the pancreas to increase enzymes production. The goal is to rest the pancreas by using a low fat, easy digestible diet. IV fluids are also part of the treatment. Disc episodeThe single most important care for a disc episode is the limited movement of the back (spine). Back moving pressures the weak damaged disc. Too much disc damage then seriously impacts the spinal cord with a predictable stepwise deterioration of functions. Avoid risky to the disc transports. Only for the most urgent of care needs as you have been doing. When possible handle things like med adjustments over the phone, updates. Ollie's nerve damage will likely self repair with time. Think in terms of months rather than days/weeks for this very slow part of the body to self heal.1. Pain caused by the intial disc tear & inflammation in the spinal cord
2. √7/12 Wobbly walking, legs cross
3. Nails/toes scuffing floor
4. Paws knuckle under
5. √7/13? Weak/little leg movement, √7/13? 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.
IVDD MEDs There seems to be conflicting information about the use of steroids or NSAIDs with pancreatitis. Discuss with your vet so you understand things and are "in" on the treatment plan. The typical with a disc episode. Pills for at home care: 1) Anti-inflammatory drug such as steroid shots or pills (Decadron, prednisolone) to get the spinal cord swelling resolves. It may take 7-30 days to achieve. Taper days are too low and not counted in the 7-30 days. 2) Pain meds to provide full comfort from pain round the clock dose to dose. Typically that means a cocktail of 3 pain meds given every 8 hrs. -- gabapentin for nerve pain -- methocarbamol for muscle contraction pain -- traMADol as the general analgesic. 3) Pepcid AC Stomach protection due to stress, anti-inflammatory, and spinal cord damage to automtomic protection. Good background to discuss things with a vet: dodgerslist.com/2020/05/06/stomach-protection/When you have time and can look at the invoice/bill, fill us in:name of steroid shot 7/12Decadron [Dex] on 7/14 pills or a shot?Your vet has done a great job in quickly diagnosing pancreatitis and also a disc episode at the same time and getting treatments underway! Let us know your vet's thoughts on when Ollie will be in position with pancreatitis to do home care only and phone for updates, med adjustments. Reserving a risky car transport should something of the most urgent need would require a trip into the vet. Again, so very happy to hear healing is going in a good direction for Ollie!!!! |
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Post by Barb & Ollie on Jul 25, 2022 6:57:33 GMT -7
I know we need to address Ollie’s disc issue yet. Can he tolerate taking oral medications (prednisone, novax, gabepentin) when recovering from pancreatitis? I don’t want to have any setback with that issue. I don’t think our vet is very well-versed in treating IVVD. Guidance please?
Please forgive me if I’m posting threads in the wrong area! I am having a hard time navigating on the site.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 25, 2022 7:30:10 GMT -7
Barb, you are in the right spot....Ollie's thread.
Bookmark this link in your browser for future returns.
It would be best to discuss the disease pancreatitis and if a non-steroidal (NSAID) or a steroid ( such as prednisone) can be used with pancreatitis for his disc episode.
I would say the first thing to know is does Ollie need an anti-inflammatory at this point in time? The only job the anti-inflammatory has is to resolve swelling. An indicator that there is still swelling is pain.
By stopping all pain meds (gabapentin, traMADol, methocarbamol) then one can correctly asses about pain.
Let us know what the pain sitatuation currently is with Ollie. Is he still taking any pain meds, then you don't have a correct assessment.
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Post by Barb & Ollie on Jul 25, 2022 8:56:35 GMT -7
The only med he is currently taking is (tapering doses) 2.5 mg prednisolone. He had a dose this morning and will finish 2.5 next Monday. He is starting injections of Adequan. I know he was given one last week, not sure if more?
I’m to call today to schedule his next injection. I don’t know if that med falls in anti-inflammatory, or a non-steroidal pain med?
Prior to this last episode (of prancreatitis/disc)
Ollie was taking Novax 25mg daily for arthritis back pain. That was stopped last week.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
14lbs 14 y.o.
Local DVM vet on 7/12
crated 7/12
Novax for arthritis stopped 7/18
7/15 currently at home w/daily trip to vet for IVDD meds, pancreatitis treatment: IV fluids.
name of steroid shot 7/12, able to wobbly walk
prednisolone as of 7/13: 5mgs 2x/day for 2 days;
decadron [Dex] on 7/14 pills or a shot?
gabapentin 100mgs 1x/day
Ollie needs GI tract protector, Pepcid AC, on board w/prednisone, Dexadron! ]
Overall he has improved. He eats well, gait is much better, and he wags his tail! He hasn’t wagged his tail in a long time.
But, he still has episodes of panting & quivering. It is hard to discern if it’s stomach or back pain, as it usually occurs after eating and/or after going outside to potty. It could also be related to being crated.
Another odd thing is he is not nearly as vocal as he typically is. Not sure why that is? He does eventually calm down and sleep.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 2, 2022 11:12:21 GMT -7
Barb, I'm so sorry your post fell thru the crack. My appoligies - I just found it today.
Will be watching for your update on Ollie.
There are things you should be aware of with the use of meds with Ollie.
Dex is very tough on the tummy. This is why we keep asking about Pepcid AC + sucrafate being on board.
Adequan can be a mild blood thinner, should the dog get an ulcer from Dex, no washout from Norvax things could get nasty (bleeding ulcers) in a very short period of time.
Adequan might, then, be held off till off all steroids. It can be good for arthritis pain after off the big gun anti-inflammatory drug Decadron (dex).
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Post by Barb & Ollie on Aug 2, 2022 15:57:01 GMT -7
Regarding Ollie: After receiving in-clinic treatment for nine day (July 12-20th) our dog is making an amazing recovery from acute pancreatitis and the disc issue is SO much improved as well. I should clarify the dexamethasone was only given once on July 13 when his pancreatic enzymes were sky high. I was told to stop the prednisolone at that time. As I mentioned, he received in-house treatments, so I am not fully aware of what was given each day and to complicate matters our vet continues with Covid practices and is treating animals, but does NOT let owners come into the clinic! So all communication is done via different vet techs when they bring the pet to the car. So, communication is not ideal and the clinic is swamped.
Ollie was started on Hill’s I/D canned dog food and tolerated well. We have since switched to the dry kibble.
On July 26th, I told staff that he is showing improvements but does some quivering after eating. Not sure if it’s stomach related or if it’s disc related from taking him potty.
The doctor started him on ✙PancreVed tablets to take twice daily (cannot see a dose/strength on bottle!) and to restart the 25mg ✙Novax once daily.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
14lbs 14 y.o.
Local DVM vet on 7/12
crated 7/12
Novax for arthritis stopped 7/18
decadron [Dex] 1 time on 7/13 for pancreatitis
7/15 currently at home w/daily trip to vet for IVDD meds, pancreatitis treatment: IV fluids.
7/12 able to wobbly walk
prednisolone as of 7/13: 5mgs 2x/day for 2 days;
gabapentin 100mgs 1x/day SToPPED?
✙PancreVed tablets pancreatic enzymes
Adequan injection 7/20, a serious of 8 injections
Pepcid AC on board w/NORVAX! ]
Within two days the quivering has subsided and his walking gait has also really improved! Although not perfect, I think his walking gait is better than it has been for the past 6 months.
He is not shedding nearly as much as he was and is wagging his tail, so maybe something has been going on longer than what we thought-that we had attributed it to his age?
When I called today to schedule an Adequan injection, I was told Ollie has had 3 injections so far-the first one on the 20th and the series is 8 injections. I have done massages on him, and did some gentle leg stretches with him, but don’t know at what point to start more exercises? We are beyond grateful that Ollie is where he is today.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 2, 2022 17:02:22 GMT -7
Barb, so VERY pleased to hear both pancreatitis and disc healing are going well. Even improvement in neuro functions of walking better!! The 8 weeks of conservative treatment with limited movement is to allow the disc to heal. So think in terms of footsteps vs walking around. At potty time carry him to and from the potty place. Allow only a very few minimal footsteps. The few minimal footsteps he takes is enough to maintain condition of joints and muscles. The focus now is all about getting the disc to heal. To avoid a relapse of the early healing disc. A relapse (re-tear of weak scar tissue) could spell severe damage to the spinal cord. Ollie has come along nicely, no way do you want to jeopardize that. STRICT REST until graduation day of 9/5 means: ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎no massages, no stretching of the legs ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy WHYs: dodgerslist.com/2020/04/22/chiropractic/ ◼︎no meandering at potty times. With both Adequan AND Norvax now in use, HIGHLY consider with the vet if an acid suppressor (Pepcid AC or a different type such as omeprazole) can be used with pancreatitis. IF Norvax would cause a bleeding ulcer, then you have blood thinning Adequan on board. Not a good situation. Pepcid AC surpasses acid production to help avoid bleeding ulcer. Let us know what your vet thinks in light of pancreatitis. Has the gabapentin stopped? If not, still on gabapentin 100mgs 1x/day? Thank you for the update, really good to hear how well Ollie is advancing in his treatments. |
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