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Post by Ramon & Caesar on Jul 12, 2023 7:14:36 GMT -7
[This post is being marked. If you have corrections or any additional info please do so in a new post so we don't miss seeing your information. Thanks!]
Hi. My dog’s name is Caesar and he has IVDD of the neck which was re-diagnosed on Thursday, July 6th. He is 14+ years old, and he is not handling this well. We are desperate to give him relief! He is being treated with Methocarbamol and 50 mg 3 x day of gabapentin for pain. He is also battling pancreatitis, which has recently flared. We haven’t set up crate rest, because he doesn’t move all day; he is a very lazy dog in that respect. How should we help him hold his neck? When ver he is laying down or going outside to pee, his head is always down. Should it be propped up at all? He also has stopped really biting into food. I have noticed changes in the way he takes treats. He only does it with his front teeth. His back has been arched for over a year, and the vet is certain the pain is in his neck. He looks like he is suffering so much! Should we put him down? The pancreatitis does not make it easy to see what’s going on with his neck since his pancreas is painful and swollen all the time.
Caesar weighs 16.5 lbs. He takes methocarbanol about 125mg 3x a day and 3x gabapentin 50mg daily. [MED LIST/HISTORY- Moderator's Note. Please do not edit
16.5 lbs 14+ y.o.
budesonide 1mg 1xday for pancreatisisSteroid dose as of 7/6 for disc episode:
?mgs ?x/day for ? days, then a test taper for: _pain / _neuro methocarbamol 125mgs 3x/day
gabapentin 50 mgs 3x/day
ursodiol ?mg ?x/day
cerenia for pancreatis nausea as needed] He’s also on ursodiol, budesonide for pancreatitis 1/2 to 1 daily @ 1 mg. He gets Cerenia for nausea as needed. He is already so sleepy and barely goes or does anything. We are considering putting him down. We’ve had him since he was a puppy, and his condition is just terrible. Before we do anything, we want to give him a shot at feeling better.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Jul 12, 2023 10:06:18 GMT -7
Ramon, welcome to the Forum. First thing to know is a disc episode is not a death sentence. The action to take is proper treatment for Caesar. What is the reason no anti-inflammatory drug is on board to deal with the root cause of his pain (head low, reluctant to chew/open mouth? Know about anti-inflammatory drugs to discuss asap with vet today Vets choose an anti-inflammatory during a disc episode to get painful swelling down in about 7-30 days. These powerhouse meds do wonders OR they can be dangerous. Vets who practice safe medicine and owners up to speed on medications make all the difference. Did you get all four questions right? - Answers here: dodgerslist.com/2020/04/18/steroids-vs-nsaids/** i.postimg.cc/9MqP4ndF/healingsweling.jpgPAIN MEDS NOrmally it will take 3 different pain meds to work on each kind of pain. Pain meds last for 8 hrs. Good to see two of his pain meds have been Rx'd for every 8hrs (3x/day)! √ Methocarbamol for muscle contraction pain 125mgs 3x/day √ gabapentin for nerve pain 50 mgs 3x/day __ traMADol as the over all general analgesic @ max analgesic dose to speak with vet about for a 16.5lb/7.48kg dog: at least 50mgs 3x/dayReading references:Extra's you can do at home to help with a neck disc: ==> dodgerslist.com/2020/05/05/cervical-care-tips/ Signs of pain related especially during a NECK disc episode. May help you to distingush from Pancretitis pain? Resolution of spinal cord inflammation/swelling provides the relief from pain. It can take an anti-inflammatory (steroid or a non-steriodal NSAID) a range of 7 to 30 days before all swelling is gone.
The best pain medications control is using more than one approach to address pain from multiple fronts (traMADol-general analgesic, methocarbamol- muscle spasm pain, gabapentin-nerve pain). All three pain meds need to be prescribed three times a day.
Adjusting meds by phone avoids a risky-to-the disc car transport. Describe the pain that you're seeing.
Advocate for the three pain meds plus a stomach protector such as Pepcid AC (Famotidine) to protect against the side effects of the anti-inflammatory.
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.
General disc episode sign of pain to monitor for ⚙︎ 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 in additioin these are the typical neck disc signs of pain: ◻︎ 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
Fill us in on the detail of all meds dose in mgs and how often given:
ursodiol ?mg ?x/day
If an anti-inflammatory is to be added, use an acid suppressor to prevent bleeding ulcers. Good reading for your understanding and being able to discuss things with your vet: dodgerslist.com/2020/05/06/stomach-protection/
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Post by Ramon & Caesar on Jul 12, 2023 10:30:31 GMT -7
Called vet to ask for anti-inflammatory a few minutes ago.
Gave him 50mg of ✙traMADol [?mg ?x/day] a few hours ago. Seems like it helped a little bit - responded to his name better.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
16.5 lbs 14+ y.o.
budesonide 1mg 1x/day for pancretitis
Steroid dose as of 7/6 for disc episode:
?mgs ?x/day for ? days, then a test taper assessment for: _pain / _neuro
methocarbamol 125mgs 3x/day
gabapentin 50 mgs 3x/day
traMADol ?mg ?x/day
ursodiol ?mg ?x/day
cerenia for pancreatis nausea as needed]
Remember that the meds he is on are not for the neck; they are to deal with the pancreas. I really don’t have anything for the neck.
The reason we even considered putting him down has to do with the chronic pancreatitis- it is causing him pain and limiting what he can eat. He does have a good appetite, but he won’t eat his dog foods anymore.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Jul 12, 2023 10:35:48 GMT -7
Ramon, just learning Budesonide is in a class of medications called corticosteroids. So with this steroid on board, Pepcid AC (famotidine) to suppress stomach acids is VERY typically used. Pepcid AC (famotidine) 5mgs 2x/day. Buy at the grocery store. Verify with vet in light of pancreatitis. thumb.ibb.co/mEGRuy/91x_Aj_s00z_L_SY355.jpg Date Budesonide started? Dose in mgs and times per day?What date will it be tapered to reveal if disc episode inflammation has been resolved. This is the usual procedure for a disc episode. However the steroid Budesonide is not usual. Was this Rx'd for pancreatitis? Help us understand his meds. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Jul 12, 2023 10:49:48 GMT -7
Ramon, call your vet now, today and discuss getting a steroid (maybe it could be Budesonide, just do not have any knowledge on that subject) up to the level needed for a disc episode. It is called the "Anti-inflammatory level"
Just as a reference the steroid PREDNISONE is the usual with a disc episode. Different steroids have different strengths and thus the dose would be different steroid to steroid
On the Forum we are familiar with vets who typcially Rx Prednisone for a disc episode:
You and your vet will have to traverse the options of which steroid is best in light of pancreatitis. Please do keep us posted on the details (mgs, times/day) the vet Rx's.
What is your city/state?
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Post by Ramon & Caesar on Jul 12, 2023 10:55:11 GMT -7
Hi! Thank you for your insight.
Budesonide is going to be a constant because his pancreas is still enlarged and inflamed. He is also supposed to get IV fluids once a week to help the pancreas.
We live near Augusta, SC.
He has a specialist there. We’ve spent (not that it matters) over $6000 this year getting him care for his pancreas. I am giving that number just to give you an idea of how much attention his pancreas has needed this year.
He has a vet locally, but he is kind of beyond their care.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Jul 12, 2023 11:16:05 GMT -7
Ramon, good to hear you have a specialist involved with pancreatitis. Now that Caesar is having another disease involved, a disc episode, a doctor must take that into consideration. Our expertise is only that of IVDD and disc episode.
However I have noticed other dogs on this Forum having pancreatitis along with being treated for a disc episode. The steroid used was prednisone.
Do your research on line as much as you can about both pred and Budesonide. Call your specialist asap to notify of the disc episode (you did not reveal important info of title of the vet diagnosing disc episode).
Hopefully pancreatitis specialist will confirm with a neuro specialist about which steroid will do the job best for pancreatis AND disc episode.
A steriod is needed up at the anti-inflammatory level to deal with the pain of a disc episode. A steroid is also needed for pancreatitis. Let us know which vet (title?) says what. I believe there is the right solution. You obviously love Caesar and are an attentive owner in pursuing help. Will be watching for your update.
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Post by Ramon & Caesar on Jul 18, 2023 7:34:10 GMT -7
The doctor said that Caesar’s anti-inflammatory is at its max dose. We have started to use Tramadol when we see him in pain, and that is working well so far. At least, he is responding to it positively.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Jul 18, 2023 8:29:07 GMT -7
Ramon, we'd like to follow along. Would you provide information about Caesar's med list?
[MED LIST/HISTORY- Moderator's Note. Please do not edit
16.5 lbs 14+ y.o.
budesonide 1mg 1x/day for pancretitis
Budesondie steroid dose as of 7/6 for disc episode:
1mg 1x/day for ? days, then a test taper assessment for: _pain / _neuro
methocarbamol 125mgs 3x/day
gabapentin 50 mgs 3x/day
traMADol ?mg ?x/day
ursodiol ?mg ?x/day
cerenia for pancreatis nausea as needed]
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