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Post by Millie & Apricot on Dec 4, 2022 10:00:59 GMT -7
[Original subject line:Millie’s Apricot - 12/3 Conservative - Maltipoo ]
We think Apricot is having another disc episode. She had one earlier this year and we posted on this forum about it (quick summery of that episode: issues first started end of March with signs of pain. Got so bad in May that she couldn’t walk. We strictly followed conservative treatment and she was fully healed by beginning of July).
She is a 7.5 pound maltipoo who is 2 years and 9 months old.
[MED LIST/HISTORY- Moderator's Note. Please do not edit ]
7.5 libs 3 y.o.
name of NSAID as of 12/3: : ?mgs ?x/day for ? days, then a test stop for: _pain / _neuro
gabapentin ?mg ?x/day
name of antacid: ?mg ?x/day ]
Yesterday evening [12/3] she was hesitant half way through her walk, walking a bit slower and less enthusiastic, tail down. She yelped when we picked her up and growled when we tried again later and her stomach was tight. These are the same signs she had for her last disc episode. She doesn’t have any neurological deficits so I think we caught it really early.
We called our vet but they are closed Sunday. The last time when we went to the vet when apricot was only showing signs of pain, they gave her gabapentin and Metacam (NSAID) for 4 days. We still have meds left so
we decided to start her on the gabapentin, NSAID, and antacid for stomach protection and we are keeping her on strict rest. I am hoping that by starting treatment early she can heal without losing any neurological function.
We are going to call the vet [12/5] again tomorrow to get their guidance on how to proceed further. If anyone has any advice for the best approach for healing a disc episode that is caught early on or for recurring disc episodes, please share.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Dec 4, 2022 12:43:39 GMT -7
Millie, so sorry to hear this may be another disc episode. It certainly has many of the signs of one. Kudos to you for crating her at once!!! Just so you know, there are other diseases which mimic some of the signs of IVDD. My comments below are based on giving the vet the best chance to observe Apricot's symptoms to be able to formulate his diagnosis. NSAIDs stay in the body for 4-7 days Pain meds like gabapentin stay in the body for 8 hrs. To give the vet the best chance to see symptoms and correctly diagnose, you can stop the gabapentin 8 hrs prior to the vet exam. A nsaid stays in the body for 4-7 days, so would not be useful to stop it for the exam time. The single most important care is the strict rest so as not to further damage the suspicion of a disc episode from then seriously impacting the spinal cord. No $1200 advanced imaging will likely be called for to visualize the disc and the spinal cord. X-rays show hard tissue like bone, but not soft tissue such as discs and spinal cord. X-rays are used to rule out "IF" a high suspicion of another disease that mimics IVDD as the vet is developing his diagnosis. So if the diagnosis would be a new disc episode, there will not be any visual of the disc and spinal cord. The vet will likely go by his visual and hands on exam and Apricot's history. Seems prudent to assume it could be a degenerated disc with surface cracks on the disc that allow a bulge. Tissue need time to heal. 8 weeks is how long it takes a disc to heal and form strong scar tissue. With IVDD the discs begin to prematurely age and degenerate starting at age 1. Apricot is almost 3 years old. You can review more about IVDD here to help you prepare a list of questions you may have for the vet's diagnosis/treatment: Shortcut Thru IVDD: dodgerslist.com/2020/06/26/time-and-ivdd/ Please do keep us updated on the Monday appt.  |
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Post by Millie & Apricot on Dec 6, 2022 18:14:03 GMT -7
Thanks for the helpful info Paula. We saw the vet today. She said to do a 10 day course of Metacam and she said we can do the Gabapentin and Famotidine too for the 10 days.
[MED LIST/HISTORY- Moderator's Note. Please do not edit ]
7.5 libs 3 y.o.
name of NSAID as of 12/3: : ?mgs ?x/day for ? days, then a test stop for: _pain / _neuro
Metacam as of 12/6: ?mg ?x/day for 10 days, then TEST STOP
gabapentin ?mg ?x/day
famotidine: ?mg ?x/day ]
She said there is no need to taper any of the medications but I read online that they are sometimes tapered. Has anyone used Metacam and did your vet taper? How many days did your vet prescribe it for?
She also said we can use Metacam as needed in the future. If we notice Apricot has back pain, we can do a 10 day course of Metacam.
The vet recommended 2 weeks rest but we are planning to rest her for longer because I know it can take 8 weeks for the disc to fully heal.
We asked the vet about nexgard [afoxolaner and milbemycin for heartworm,tick, flea] because we know it can have neurological side effects. She said that it can cause seizures but since Apricot doesn’t have seizures it is no more risk than in dogs without IVDD. Basically she said the neurology effects of IVDD and seizures are completely unrelated. I'm not 100 percent convinced they're not contraindicated, so wondering if this is the general consensus.
We are planning to get the Assisi loop lounge. Our friend who has a dog with IVDD uses the Assisi loop and has found it to be very effective. Does anyone have experience with the Assissi Lounge? I was looking at the lounge as opposed to the loop because it is rechargeable and I think it would be good to use long term for apricot as a preventative measure
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Dec 6, 2022 20:29:21 GMT -7
Millie, what is the name of the vet's diagnosis? With your reporting tail down, what part of the back did the vet think is likely affected?
Non-Steroid anti-inflammatories like Metacam do NOT need to be tapered.
Steroid anti-inflammatories like prednisone MUST be tapered
Pain meds do not necessarily need to be tapered and often we see vets do not taper them. However, a vet knows the animal being treated and there could be in some situations, a need to taper pain medications. Apparently not the case for Apricot.
MED LIST update?
name of NSAID as of 12/3: : ?mgs ?x/day for 3 days,
Metacam as of 12/6: ?mg ?x/day for 10 days, then 12/6 TEST STOP
gabapentin ?mg ?x/day
famotidine: ?mg ?x/day
We have heard reports of the Assisi loop being helpful for pain and healing.
You can do research and study on the ingredients listed for any heartworm med and decide which of the various product could/would be better suited for Apricot.
Determining if another product has the same specifications as the Assisi would be a good idea to zero in on. Maybe your vet has a recommendation for you?
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