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Post by Sarah & Tyson on Feb 11, 2023 1:44:33 GMT -7
[This post is being marked for clues. If there is a correction or additional info, please do so in a new post. Thanks!]
[Original subject line:4 year old Frenchie, neck IVDD ]
Hi, I’m so glad this page exists! Our nearly 4 years old, 16kg frenchie Tyson was playing tug on Monday [Feb 6] (06/02) when he suddenly jumped in pain and couldn’t stand properly.We rushed him to the emergency vet who gave an anti inflammatory injection and said he’ll be fine in the morning.
He wasn’t fine so we took him to [Feb 7] our vet who hospitalised him straight away with suspected early stage 1 IVDD in his neck, just before his shoulders. He was walking normally now but was in pain. They gave him morphine and a sedation because he was extremely anxious and panting. I’m not sure what else, but she said he’d be more comfortable at home so we brought him home Wednesday [Feb 8] (08/02) for strict crate rest. 3 weeks and then a check up, with calls in between to update.
Medications:
Gabapentin 100mg every 8 hours
Melaxocam one dose 9am with food
1/2 paracetamol twice per day
[MED LIST/HISTORY- Moderator's Note. Please do not edit
16 kg/35.27lbs 4 y.o. London UK
name of anti-inflammatory injection at ER Feb 6th?
Rheumocam® (Melaxocam) as of 2/7 (1.5mg per ml) ?mg (mL dose?) 1x/day for ? days, then test STOP: _pain/_neuro
gabapentin 200mgs 6x/day
diazepam 10mg tab: 5mg 2x/day
Pardale (paracetamol 400mgs/codeine 9 mgs tab: ?mgs 2x/day
Amantadine 100mg 1x/day only if neccessary. not currently giving
Tyson needs GI tract protector, Pepcid AC, on board for duration of Metacam!]
He’s fine all day, walking normally, bored in the crate and wanting to go out. Peeing, eating, pooping as normal. But once a day for about 30 mins he has what looks like a muscle spasm attack. He puts his head to the ground, bum in the air and is completely tense and shaking and panting. It lasts around 30 mins then he sleeps and is okay again. Seems to coincide with next dose of gabapentin being nearly due.
Vet suggested doubling the gabapentin and gave two more medications:
1/2 diazepam every 12 hours
Amantadine if he’s having a lot of pain and needs something extra. Once a day only if necessary.
The double gabapentin didn’t seem to work, he was really drowsy and out of it and still had a pain attack near to the next dose. So we’re trying spacing it out, 100mg every 4 hours so he’s got a constant dose and doesn’t get spaced out. It’s not been a full 24 hours yet so we don’t know if this plan will work.
Current medications:
Gabapentin 100mg every 4 hours
Meloxicam one dose with food 9am
1/2 paracetamol every 12 hours
1/2 diazepam every 12 hours
Amantadine only if needed.
We also have been told he needs to lose some weight. He had aspiration pneumonia last June that required lung surgery so he couldn’t exercise until recently which led to some weight gain.
Thank you so much for any help. We’re very anxious!
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 11, 2023 9:55:05 GMT -7
Sarah, we are very glad you are here. Our number one goal is to help owners get things right for their dog. Clearly the medications are not yet right if pain is surfacing. Below are the things you can discuss asap today with your vet to get full round the clock pain control in effect. If it takes phoning the ER vet then do that. Clinics where Tyson has been seen, means any vet at that clinic can refer to his file and adjust meds over the phone. This avoids a risk the disc trying to heal. Anytime Tyson is out of his recovery suit is a danger to the disc. Ditto with car transports. All the IVDD pain meds last for about 8 hrs. This is the reason for his pain. There are very typcally three sources of pain. Each must be covered. In a new post give us the missing details about his med list, so we have all the fact to best comment. -- name of anti-inflammatory injection at ER Feb 6th? -- Meloxicam as of 2/7 ?mg 1x/day for ? days, then test STOP: _pain/_neuro -- gabapentin 200mgs 6x/day -- diazepam ?mg 2x/day -- paracetamol ?mgs 2x/day -- Amantadine ?mg 1x/day only if neccessary -- Tyson needs GI tract protector, Pepcid AC, on board for duration of Meloxicam! DISCUSS WITH VET TODAY, asap -- Gabapentin (nerve pain) 100 mgs or 200mgs may well do the job with a more sane dosing schedule when the other meds are correctly on board. Dosing gabapentin every 4 hours means you are not getting needed rest to have clear thinking when caring for your patient. HOWEVER, if necessary then of course you'd do 6x/day dosing! Advocate for Gabapentin every 8 hrs at mg dose that avoids over drowsiness. Try either promptly 100mgs 3x/day (every 8 hrs) or 200mg 3x/day to see which does best. Reading reference: -- Diazepam (muscle relaxer) may work for some dogs. Mostly methocarbamol is used for those very painful muscle contractions with a neck disc. Reading reference from Ortho surgeon, Dr. Fingeroth: Amantidine is something that is not a pain med BUT can help with pain. It is not given as needed when you see pain, but given promptly 2x/day if intended to pain from surfacing. The Mar Vista vets explain the mysteries of amantadine www.marvistavet.com/amantadine.pml Reading Reference: --Pardale is a combo. Paracetamol® (acetaminophen) + opiate codiene in one tablet The usual general analgesic is the synthetic opiate traMADol. There is no one fits all pain med approach. Discuss if another pain med could help better prevent pain surfacing for Tyson === END of post==== |
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Post by Sarah & Tyson on Feb 11, 2023 10:08:00 GMT -7
Diazepam 10mg tablets, [5mgs] half every 12 hours
Paracetamol is called pardale? Can’t see any mg on the jar
Amantadine 100mg
Meloxicam is 1.5mg per ml. Also contains 0.5mg of sodium benzoate - brand rheumocam®
No pain attacks yet today! Fingers crossed…
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 11, 2023 10:51:33 GMT -7
Sarah, glad to hear so far pain is fulled controlled dose to dose. Lets write dates out to avoid confusion between 2/11 and 11/2. I mean Feb 11, for example. The goal is full pain control and if at all possible to not have the care give (you) having to awaken to give a dose during sleep hours. You have my comments in case you need to advocate on the phone to ER vet or your own vet. Vets here in the States are closed mid Saturday and Sunday. So hope Tyson will be ok thru the weekend. Please keep up updated Tyson's pain control. Also what was the name of the anti-inflammatory injection at ER on Feb 6th?
how many days is Tysone to take Rheumocam® (Melaxocam). This would be important information for you to have to be prepared. Every vet must take a guess as to how long it will take to resolve all swelling. It can range from 7- 30 days. No one wants a dog on Meloxicam any longer past the job completed. Often the course will be a 7-day or even a 14-day course of meloxicam. Please read up on your job at home when Meloxicam is scheduled to stop: dodgerslist.com/2020/04/18/steroids-vs-nsaids/Let us know when you have Pepcid AC on board to suppress the acids stress, pain, change in routine and meloxicam all cause. |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Feb 13, 2023 6:47:54 GMT -7
I'd like to also welcome you to Dodgerslist, Sarah. Prayers that pain is now completely under control. Here are some tips on strict crate rest in addition to the excellent information Paula has given you regarding the pain emergency. The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. Super tried and true tips for setting up the recovery suite, the mattress and more! —> dodgerslist.com/2020/05/14/strict-rest-recovery-process/STRICT means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy whys: dodgerslist.com/2020/04/22/chiropractic/ ◼︎no dragging or meandering at potty times. ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎At home laser or acupuncture for severe neuro damage is best. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog’s back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to a minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! dodgerslist.com/wp-content/uploads/2020/04/Potty-leash-harness400-19kb.jpgIf Tyson is too big to carry, it is still important that the amount of movement to the potty place be minimized. Try a pee pad right outside the crate. Add caster wheels to a wire crate and wheel down ramp over steps to outside. With a cervical issue, there are a few other things that should be done, such as raising the food and water dishes so your dog doesn't have to bend neck, moistening hard kibble to soften, etc. dodgerslist.com/2020/05/05/cervical-care-tips/You mentioned that your vet wants a check up in three weeks. Any time out of the crate is a dangerous time for a dog healing with conservative care. Vets who understand the importance of limitation of movement of the spine will agree to receiving phone updates from you rather than dangerous trips to the vet. All vet visits during conservative treatment need to outweigh the risk of being out of the crate, transport in the car, etc. Please speak to the vet about his reasoning for a check up in three weeks and advocate strongly for phone updates instead. Meds can be adjusted by phone and really that's all that's needed other than the 8 weeks of strict crate rest. Should you absolutely need to take Tyson to the vet, be sure to have a crate that is secured firmly in the vehicle and pad out the crate's extra space with rolled up blankets so his body will not shift during breaking or cornering. Please continue to keep us fully updated. Healing prayers for Tyson. |
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Post by Sarah & Tyson on Feb 13, 2023 7:16:50 GMT -7
Thank you both so much. The staggering of meds hasn’t worked and he’s still having one episode of pain per day. I can’t even correlate it to anything at this point, it seems random.
The vet who is treating him is off until tomorrow but I’m going to speak to a different branch today to see if they have any suggestions for today. It’s horrible to see him be in so much pain and it’s strange that it just comes on for 30 mins and he’s fine the rest of the time. Yesterday it came on one hour after his gabapentin dose. Hopefully the vet today can offer some solution.
He’s also hating crate rest and grumbling at me all day! Because it’s in his neck I’m wary to give him any toys. Have you found it’s better to leave them alone or sit in with them all day? I think he’s finding it frustrating that I’m in the room kind of ignoring him when he would usually be on my lap!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 13, 2023 10:55:47 GMT -7
Moderator Paula is reading your post and preparing a reply. Refresh your browswer time to time to see new reply. OR better yet, set up to get auto email alerts if you've not yet done so: 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! |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 13, 2023 11:33:04 GMT -7
Sarah, so sorry the current pain med dosing is not doing the job. When you give us details to work with, then we have the ability to make specific comments to help you with discussions with your vet. Please bring us update to date: Let us know when you have Pepcid AC on board. Tyson does not need another problem of bleeding ulcers to deal with on top of this painful neck disc. What was the name of the anti-inflammatory injection at ER on Feb 6th?How many days is Tyson to take Rheumocam® (Melaxocam).Pain meds last for about 8 hrs.The big key to pain control is covering each kind of pain every 8 hrs. If one of the pain meds is not doing the job, then trying a different pain med.Nerve pain Gabapentin at minimum every 8 hrs. You are giving every 6 hours.Muscle contraction pain at minimum every 8 hrs. Diazapam is being given every 12 hrs. Often diazepam does not work well. METHOCARBAMOL seems to work best for most dogs. Reading reference to be able to discuss this med with your vet: marvistavet.com/methocarbamol.pmlGeneral analgesic Pardale (acetaminophen 400mgs/codeine 9mgs ) is being dosed every 12 hrs. Different meds are used in different countries.
In the States, Pardale is not something we are familiar with on the Forum including how often can this two-med combo tablet be dosed.
Perhaps below readings may help you to discuss if an alternate general analgesic or frequency may work better for Tyson's particular need to get the pain fully in control? FYI, we are more familiar seeing on the Forum, vets and surgeons using traMADol as the overall analgesic
Reading reference: marvistavet.com/tramadol.pml
2 Reading references:Please do keep us updated, most hopefully, today that the meds got adjusted. What are the new adjustments? Expect that within the hour of dosing pain should be in control and that full pain relief lasts night and day, dose to dose. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 13, 2023 11:36:12 GMT -7
Sarah do you have a sturdy coffee table you can put the wire crate on. Then pull it right up to the couch or your chair. Then you two can sit together kind of. Yuu can touch Tyson thru the wires. He can feel and smell the warmth of your legs resting on the coffee table against his crate. Often dogs do like being up higher to see around their home.
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Post by Sarah & Tyson on Feb 13, 2023 13:58:05 GMT -7
Thank you so much, I’m not sure which anti inflammatory injection he was given at the vet.
We also haven’t been told when to stop the Melaxocam yet. We’ll be speaking to our vet tomorrow so I’ll ask and also ask re the Pepcid.
I sent a video to a different branch hoping for some help but they haven’t called me back. As our vet is back tomorrow I’ll raise it all with her instead and hopefully she will be able to amend the current medication to something that works better. Im praying that a medication change is all he needs and this isn’t a sign that he’s not responding to the conservative care. Im an anxious wreck!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 13, 2023 14:37:30 GMT -7
Sarah, the key to be able to carry on with conservative treatment is that all pain can be fully controlled with pills at home. There is a lot in the medicine bag that still can be used by the veterinarian to give that relief. If at some point a surgery might be considered, you should know all the facts ahead of time. Always be prepared. This is a very good overview of the two treatments (surgery, conseravative): dodgerslist.com/2020/02/10/surgery-vs-conservative/ **Would a surgery be something that could fit your family's budget? The anti-inflammatory injection should have been listed on your bill. It's part of the treatment, so you should know and we want to know. Every vet has to take a guess on how long to use Meloxicam (maybe a 7-day course, maybe a 14-day course. You should privy to all parts of the treatment to be a knowledgeable IVDD pet parent.. Ask questions is how we all learn. Got my fingers crossed to get meds adjusted asap today????? The sooner Tyson can be out of unnecessary pain, the better healing can then proceed. Pain deters healing. |
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