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Post by NIkki & T Rex on Nov 3, 2022 19:24:03 GMT -7
Nikki's T Rex date of? conservative -Chi
hello,
my pup has recently [date?] suffered another disc episode and after several failed attempts to get his pain under control, we decided to switch vets. we got a new xray and it shows narrowing at c5-6 and c6-7 also at the thoracolumbular junction.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
10 lbs 8 y.o.
2nd X-ray new vet: 11/1
pain 11/3
9/15 pred injection at old vet
prednisone as of 9/16: 2.5mgs 2x/day for 5 days, then test taper: √pain date?
as of 9/30: 2.5mgs 2x/day for 5 days, then test taper: EOD? pain/
as of 10/26 : TAPER DOSE:2.5mgs 1x/day test taper for: _pain / _neuro
gabapentin 50 mgs 3x/day
amantidine 25mgs 1x/day
methocarbamol 62.5 mgs 3x/day
Rex needs GI tract protector, Pepcid AC, on board for duration of any prednisone ! ]
new ver has plaved him on gabapentin 50 mg every 8 hrs 3 times a day, amantadone 25 mg every 24 hrs, and methocarbamol 62.5 mg 3 times a day. also will be using dasuquin and duralactin. she could not put him on an nsaid(i forget which one she said) yet bc he is also currently finishing up a tapering dose of steroids that the original vet had him on.im very nervous to give these huge increase in doses esp as he does seem to now be ok in the moment
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2022 19:32:36 GMT -7
Moderator Paula is reading and preparing a reply. Please refresh your browser to see newest post.
Please make a new post and give the history of prednisone. The date of the disc episode
Steroids like prednisone are the most powerful of anti-inflammatories.
Non steroidal (NSAIDs) are the lessor class. IF pain was not able to get in control why move to a lessor ,anti-inflammatory?
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Post by NIkki & T Rex on Nov 3, 2022 19:48:55 GMT -7
he has been on and off with episodes since 08/23/22, each time he completes either a round of nsaids or steroids, his pain is back bc he walks a litle funny and puts his head down. in total there have been 3 rounds of steroids at different tapered doses.the most recent round of
steroid [prednisone?] started 10/26/22 at 1/2 5 mg pill every 24 hrs for 7 days then 1/4 tablet every other day for 7 days.
he had new xray on 11/01/22.
when taken in in on 11/01/22 he showed no signs of pain.
today [11/3] he has shown some pain every now and then
so i guess my concern is if he should be taking all of the above meds if he does not seem in pain currently , but soley based on the xray findings...
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2022 19:53:11 GMT -7
Nikki, sorry to hear another disc episode. Please use dates when mentioning events, change in painfulness, change in meds, etc. Would appreciate having the history of prednisone. The important part of part of prednisone is the days on the anti-inflammatory level doses 2x/day. Any tapered (lower mgs and/or less frequency) do not work on swelling. It can take a NSAID or a steroid such as prednisone up to 30 days to resolve painful inflammation. Did pain surface with a pred taper? Or was pain never gotten in control since the disc episode happened. What date did prednisone start? The dose in mgs, frequency? Was there an attempt to taper prednisone and pain surfaced? What was the date of the taper. Is there a reason he is not on a stomach protector such as Pepcid AC? Does he still weigh 10 lbs. How old is he now? Currently what do you observe about pain. List only what you see.
There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock.
SIGNS OF PAIN: ⚙︎ shivering-trembling ⚙︎ yelping when picked up or moved ⚙︎ 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 NIkki & T Rex on Nov 3, 2022 19:58:59 GMT -7
i updated previous post with all steroid doses.
yes hos pain seemed under contrill while on steroids.
each time [DATES?] thr tapered dose ended is when i would see a change, hunched over, occasional yelping, sometimes trembling, constant licking of paws, couldnt get comfortable at certain times. previous vet never reccomended GI meds.
he is still 10 lbs and 8 years old
Aalso of note, he does suffer from seizures but has nevervtaken meds for that
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2022 20:01:00 GMT -7
I simply do not understand why you went to a new vet when your dog was not suffering pain.
There is a specific way to know when all painful inflammation is gone or not gone.
On the pred taper, the pain meds are stopped. This gives YOU at home an opportunity/ a test to quickly and accurately monitor for pain.
Something is missing on the reason you went to the new vet, rather than doing the prednisone taper ALONG with stopping pain meds. Can you fill us in?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2022 20:01:59 GMT -7
Once your post has been marked, make any changes or additions in a new post.
Otherwise we can miss important information. I'll go back to see what is new that you have written.
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Post by NIkki & T Rex on Nov 3, 2022 20:03:50 GMT -7
i wanted a secind opinion bc he had been suffeeing on/off since august and my vet kept doing the sane thing on..get snd over and we thought something more could be done for his quality of life. today was first day with zero steroid bc he is now on every other day taper and he was screeching some
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2022 20:28:54 GMT -7
Coming in at this point much blow by blow history with dates is not available. So my comments are in general.
Conservative treatment is 8 weeks to get the disc to heal. It may have been too early to be transporting him to a vet for a consult it was not yet proved all swelling was gone.
Taper with pain meds on board blind fold you to seeing the truth about pain.
Xray could have moved his back wrong way, transport too much movement.
At this point in time, the idea of switching to a NSAID is worrisome.
EITHER there must be 5-7 days without before use of the lessor class NSAID or double stomach protection (Pepcid AC plus Sucralfate)
If it were my dog I would call up your own vet. Tell him of pain due to either taper finally revealing pain or that your dog moved too much (FYI, you know... the xray, the trip to the new vet).
Expect if you can get another short course of pred (3-5 day course). THEN on the taper work out with your vet to STOP the pain meds. You want to find out asap if all swelling is gone. Not delay finding out at the end of the every other day taper doses. Do you see what I'm saying, don't blindfold yourself about pain with pain meds being on board during a taper? With a disc episode on 10/26 that would make graduation day on Dec 21.
Make sure you finish out the 8 weeks of rest. Keep Rex at home in his suite. Carry him to and from the potty place. At the end of the 8 weeks when he graduates on 12/21 then you might think about the future.
Something to think about for the future.
There are som e dogs where the disc material just will not strink back enough to no longer aggravate the spinal cord nerves. In that case AFTER ALL 8 weeks of rest are completed and the disc has for sure self healed, the dog may need to be on a light compliment of pain meds to enjoy life. Just like for some people, they take modern pain meds to be able to enjoy life.
However, if it is another disc episode that involves neuro diminishment (wobbly walking or worse), that is a new disc episode that needs the usual disc episode medications, 8 weeks to heal the disc.
In a new post please correct or add if the below MED LIST needs it.
Had prednisone ever been given 2x/day. The anti-inflammatory dose is usually given 2x/day
[MED LIST/HISTORY-
10 lbs 8 y.o.
2nd X-ray new vet: 11/1
pain 11/3
prednisone as of 10/26 : 2.5mgs 1x/day for 7 days, then a test taper for: _pain / _neuro
gabapentin 50 mgs 3x/day
amantidine 25mgs 1x/day
methocarbamol 62.5 mgs 3x/day
needs GI tract protector, Pepcid AC, on board for duration of any prednisone !]
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Post by NIkki & T Rex on Nov 3, 2022 20:48:55 GMT -7
i switched vet becausr when he had episode in 2020, your posts said my vet was giving dangerous combo of meds and very undermedicated so thought it would be wise to get a vet on board with better meds since old vet was a concern.
yes there was twice a day dosing with prednisone in 1st 2 rounds as outlined above with dates. you are now very much confusing me but i do appreciate the detauled info! that's helpful
i had all prednisone dates and doses listed above somewhere and now they are gone
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2022 20:54:04 GMT -7
I also could not find your corrections to meds. That is why I posted the MED LIST and asked for you to look it over
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Post by NIkki & T Rex on Nov 3, 2022 20:58:08 GMT -7
what you have listed there is correct!!
and here is prednisine history :
09/15/22 prednisine injection at vet
9/16/22 prednisone 5 mg 1/2tab every 12 hours for 5 days then 1/2tab every 24 hrs for 5 days, then 1/4tab every other day until gone
09/30/22 prednisone same as above
10/26/22 prednisone 5 mg 1/2 tab every 24 hrs for 7 days they 1/4 tab every other day for 7 days
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2022 21:17:22 GMT -7
Nikki, the Oct 26 Rx was for a taper dose. If Rex had not been transported had not gotten an xray, he may have well have gotten all the swelling down even on an extended 10/26 taper dose RX. Since pain meds had still been on board, one will never know. So that's history. Now lets see what can be done to help Rex.
All we know now is that Rex is painful. YET he continues with a taper pred dose. Now that he has shown pain, it would seem sensible to have another short course of prednisone up at the anti-inflammatory level (2.5mgs 2x/day).
To give a NSAID as the new vet wanted without even any proof all the pain was gone means Rex goes without any anti-inflammatory pred for days. Not good for Rex's pain.
You need to discuss with some vet. It seems the new vet may be leery to use prednisone and thus his desire to switch to a NSAID? You will have to decide which vet at this point can help Rex fastest.
It may be original vet who can do that— prescribe the anti-inflammatory level dose of pred for a short course of maybe 3-5 days to try and get all painful swelling down (fingers crossed it won't take more days). THEN when time for the taper, expedite getting a true read on swelling by STOPPING all pain meds on the day of the pred taper.
What is the date of the final every other day (EOD) prednisone dose he is on now?
Please keep us updated tomorrow after contact with a vet as to what changes in meds were decided on.
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Post by NIkki & T Rex on Nov 3, 2022 21:25:59 GMT -7
thank you for your input!i think you have a clear picture now.
the new vet was actually discussing being in an nsaid possibly for life to keep pain episodes under control but she did say she couldnt at this point bc of the steroid taper.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2022 21:30:39 GMT -7
Well, maybe the new vet will give a short pred course (?) and if at the end of 8 weeks for the disc to heal if there is still pain and NSAID would be a modern medicine to let Rex enjoy life.
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