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Post by Analisa & Gatsby on Aug 11, 2022 10:06:39 GMT -7
☆ 1 currently pain? Yes....
Neck??
X reluctant to move much in crate such as shift positions or slow, ginger movements
X yelping when picked up or moved
X tight tense tummy
X Arched back
X head held high or nose to the ground
X Not their normal perky selves?
2 43lbs 8 yrs
A..current meds
-Gabapentin 100mg, every 8-12 hrs
-Methocarbamol 500 mg, every 8 hrs
-Carprofen 75 mg, 1/2 every 12 hrs
date of a NSAID stop?
C. He is not currently on Pepcid AC, vet did not advise of this.
☆ 3 -- red flag signs of stomach damage.-N/A
☆ Cocker Spaniel- Gatsby. Analisa
☆ 5 diagnosis? - Unsure, we have not done an MRI yet. Vet (general DVM) said it is likely IVDD from the symptoms which started a few days after his teeth cleaning. Xrays were taken however, we understand IVDD doesnt not show.
☆ 6 saw the vet? 07/29/2022
☆ 7 bladder control?-Yes, however, he is in so much pain most of the day he doesnt want to even move or get up to use the restroom.
☆ 8 He walks normally other than keeping his head low [neck disc PAIN]. Generally, he will not get up or even move in the cage as he is in extreme pain.
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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 11, 2022 13:12:15 GMT -7
Analisa, have no patience with pain. Call your vet right away and advocate for a more aggressive pain med approach. Sounds very much as though the disc is in the neck. This location can be a lot more painful.
Advocate for each source of pain to be treated aggressively. Pain meds every 8 hrs (3x/day)
Gabapentin for nerve pain. Let us know if you have promptly been giving every 8 hrs?
traMADol as the general over all analgesic
Advocate for the usual in controlling disc episode painat the higher end of the mg range AND promptly every 8 hours.
methocarbamol for muscle contraction pain. Discuss if an adjustment in mgs is needed for the promptly every 8 hrs dosing.
43 lbs/ 19.5 kg Gatsby
If still pain after adjusting pain meds aggressively, discuss fentanyl patch.
Pepcid AC is a must while on Carprofen!
The usual dose of Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory.
--The dose of famotidine may require reduction in patients with liver or kidney disease.
-- It may be prudent with heart patients to choose another class of acid reducer.
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Post by Analisa & Gatsby on Aug 12, 2022 7:37:36 GMT -7
Update 08/12/2022: Thank you! Gatsby has been in and out of pain for sometime now but I wasn't too sure if that was just part of the healing process. After finding and posting on this forum, I discovered he should not be in pain, especially at such a high level. I actually switched vets [8/11] since yesterday and feel a lot more comfortable. So does Gatsby. The vet didn't change his meds much but replaced the carprofen with ✙prednisone 5mg [For how many days?] (1.5 tabs every 12hrs). [MED LIST/HISTORY- Moderator's Note. Please do not edit
43lbs 8 yrs 7/29 disc episode; GRAD 10/24
Carprofen 75 mg, 1/2 every 12 hrs stopped 8/11
Prednsone 5mg tab as of 8/11: 7.5mgs 2x/day for ? days, then test taper
Gabapentin 100mg, every 8-12 hrs Which 8 or 12??
Methocarbamol 500 mg 3x/day
Pepcid AC and Sucralfate  ?? stomach protection] Not sure if that is what did it but he's not in as much pain, literally overnight. -Gatsby is walking to use the restroom with no signs of pain. -He's breathing is slowed and stopped panting. -Sleeping in a more relaxed position and moving comfortably in the kennel. He's not at 100% just yet however, hoping its all uphill from here. |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 12, 2022 7:40:33 GMT -7
just reading quickly. Does Gatsby have DOUBLE stomach protection with a switch to pred if no 5-7 days off washout from carprofen was not done....pepcid ac + sucralfate????
still reading your post
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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 12, 2022 7:49:08 GMT -7
Analise, please detail the meds for us
Which do you actually give gabapentin every 8 or 12. Should be every 8hrs dosing!!
Very concerned if the stomach is being protected by both Pepcid AC and the Rx item sucralfate. They work in different ways. A Must if there was not 5-7 days of washout from the carprofen.
IF the pain med are correct then expect FULL pain control in one hour. "not as much pain" is not good enough. Call the vet and advocate for traMADol also 3x/day
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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 12, 2022 7:53:51 GMT -7
Since Gatsby was in such extreme pain for so long, it may take more pain drugs to get the pain back in control. Discuss these with your vet Amanatidine When pain meds are properly used at the aggressive dose and 3x/day but pain is still not fully controlled, then bring to the discussion with your vet the addition of amantadine for further control of that tough pain. Pain is a complicated issue. Often it will take 3 pain med for full control. Each pain med works on a different type of pain. Amantadine is something we are seeing neuros Rx as part of the pain med cocktail as it allows other analgesics to function more effectively . Learn why the stomach needs protection with an acid supressor (Pepcid AC) and now if no washout sucralfate to be able to advocate for these: dodgerslist.com/2020/05/06/stomach-protection/ |
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Post by Analisa & Gatsby on Aug 12, 2022 8:39:18 GMT -7
They did not advise me of the sucralfate and I was not aware he would need it. I did let the vet know he was on the carprofen and was told it was okay as long as the last dose was about 10hrs prior. I didn't realize it could have a serious impact.
However, I did get him the Pepcid ac.
Sucralfate is something the vet would have to prescribe, correct?
As for the ▲Gabapentin, I was giving every 12hrs but increased that to every 8hrs.
Sorry, I should clarify on the "not as much pain."
I only said that because I cannot tell if he is masking any pain. As far as showing any, he is not.
No crying, moving around and picking up his head great. He has stopped shaking and there has been no panting.
Just took him out to use the restroom and had to stop him from running and trying to play with a toy.
This is a complete 180 from the days prior.
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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 12, 2022 10:41:41 GMT -7
Stand up for Gatsby and strongly advocate for getting a prescription to sucralfate. Take no chances with potential of bleeding ulcers. Gatsby has been thru enough already. Carprofen takes 5-7 days to leave the body depending on the dog's metabolism. So there IS carprofen in his body at the same time as you are dosing prednisone!!!!!! Vets who practice safe medicine will look for a 5-7 day washout from a NSAID (i.e.metacam, carprofen etc) to a glucocorticoids (i.e. prednisone, etc) unless an emergency calls for a faster switch. If deemed an emergency to try and prevent further loss of neuro functions it is a high consideration to double protect the stomach with not just Pepcid AC, but adding sucralfate. ========= Use gastroprotectants to either treat suspected gastropathy or prevent its occurrence, especially if no washout period occurs. Proton pump inhibitors, H2 antagonists [Pepcid AC], misoprostol (the drug of choice in humans), and sucralfate can be helpful. ~American Animal Hospital Association (AAHA). "Nine ways to minimize the risks of nonsteroidal anti-inflammatory drugs (NSAIDs)" 2015. www.aaha.org/aaha-guidelines/pain-management-config/implementation-toolkit/nine-ways-to-minimize-the-risks-of-nonsteroidal-anti-inflammatory-drugs-nsaids/
What for red flag signs of GI tract damage. Not eating well, nausea, vomit, loose stool or diarrhea. BLEEDING ULCER goes to black or red blood in diarrhea. |
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Post by Analisa & Gatsby on Sept 14, 2022 8:55:30 GMT -7
Wasn't sure where to post this.
Gatsby was doing excellent 24hr after starting Prednisone at 1 1/2 tabs (5mg) every 12 hrs. He bounced back great for 2-3 weeks and we slowly started to taper him off.
However after the checkup he had another major flare up. Vet said to start the Prednisone 1 1/2 tabs (5mg) every 12 hrs again.
This time it didn't help at all. He couldn't even get up to use the restroom. We scheduled an appt with the neurologist and they ordered imaging. After we got a call stating the best option was surgery especially since we've tried 2 months of conservative treatment with no improvement. My little guy goes into surgery today. Hoping for the best.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 14, 2022 9:27:27 GMT -7
Analisa, sorry to hear about Gatsby. We look forward to hearing updates about the surgery as you learn more.
Were you able to stick with the very STRICT rest to heal the disc all along targeting Oct as the graduation date?
Neck discs can be difficult to heal. Let us know if the surgeon says this is the same neck disc as 7/29 or a new disc.
May this surgery give Gatsby the relief he needs.
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Post by Analisa & Gatsby on Sept 16, 2022 17:15:10 GMT -7
Yes, during the time he was on conservative treat we kept him on VERY strict create rest. It wasn't until the vet check up that he left the kennel for longer than 5-10 mins. Unfortunately, he just couldn't heal on his own.
He is out of surgery and back home now.
Vet said it was a very large rupture between c2/3. This is the only issue the noted.
Gatsby is back to his normal happy self. It's incredible. Now it's just a matter of healing his sutures.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 16, 2022 19:32:00 GMT -7
Analisa, so very glad to hear the surgery relieved the pain and he is feeling his normal self again. Were any meds sent home: name? mgs how many times a day?
For how many weeks did the surgeon want for post op rest? Often it can be 4 weeks but other cases may warrant 6weeks.
What did the surgeon want for at-home PT? I remember when mine came back after a neck operation (never could achieve the necessary pain control with aggressive pain meds to continue with conservative treatment), she was allowed to walk to and from the potty place. What did did your surgeon recommend for Gatsby?
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