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Post by Terri & Zero on Aug 31, 2023 19:20:20 GMT -7
☆ 1 Is there still currently pain?
☐ shivering, trembling
☐can’t find a comfortable position, appears restless
☐Not their normal perky
★2 How much does your dog weigh? 15 pds Age? 14.5 years old
Gabapentin 250 mg 1.5 ml every 12 hrs started 8/29/23
Metacam 1.5 ml 1 per day started 8/29/23
Famotidine 20mg 1/2 tablet every 12 hrs started 8/29/23
Robaxin 500mg 1/2 tablet every 12 hours started 8/29/23
Tramadol 50mg 1/2 tablet every 12 hours started 8/24/23
Prednisone 5mg 1/2 tablet every 12 hrs for 5 days then
1/2 tablet once per day until 8/29/23 started 8/24/23 stopped 8/29/23
[MED LIST/HISTORY- Moderator's Note. Please do not edit
15 lbs 14.5 y.0.
Prednisone as of 8/24: 2.5mgs 2x/day for 5 days, STOPPED⚠️, not tapered on 8/29
Metacam as of 8/29: 1.5mL 1x/day for ? days, then TEST stop for: _pain? __neuro?
gabapentin formula ?mgs/?mL: ?mgs 2x/day
Robaxin 250mg 2x/day
traMADol 25mgs 2x/day
Famotidine 19ngs 2x.day]
☆ 3 -- stomach damage? No
☆ 4 Dachshund. Zero. Terri
☆ 5 diagnosis IVDD Yes General DVM
☆ 6 🔘 date you saw your own vet for CONSERVATIVE treatment? 8/24/23
☆ 7 🔘 bladder control? Yes
★8 Currently can your dog wobbly walk? Yes
move the legs at all? Yes
wag the tail when you specifically do some happy talk? Yes
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Sept 1, 2023 6:23:58 GMT -7
Welcome to Dodgerslist, Terri. So glad you’ve joined us all. We’ve got valuable information we’ve gleaned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you. Know more about us and how we team up with veterinarians: dodgerslist.com/about-team-dodgerslist/You have a pain emergency that must be addressed ASAP this morning. Call your vet and advise them of the signs of pain that you're observing so Zero's meds can be adjusted. Robaxin, Tramadol and Gabapentin all work best when given every 8 hours (3x/day) as they have a short half life. The dosages of each of those meds can be increased also. Have no patience with pain as it does hinder healing and there are many options to get pain completely under control. Pain should be completely under control within one hour of giving new course of meds and should remain completely under control from one dose to the next with no sign of pain arising. An anti-inflammatory dosage of Prednisone must be started ASAP. Pain indicates that there is still swelling pressing on the nerves of the spine and still a need for an anti-inflammatory. It's that pressure on the spine that causes pain and can cause the nerves to the spine to be damaged. It's imperative that you speak to the vet ASAP to advise of the sign of pain/swelling that you're observing so an anti-inflammatory dosage of Prednisone can be given for a bit longer. Please speak to the vet about the dosage of Prednisone given ASAP. With a dog weighing 15 lbs., the anti-inflammatory dosage would be 5mg every 12 hours (2x/day). Anti-inflammatory doses range from 0.1 to 0.3 mg per pound (0.2 to 0.6 mg/kg) up to twice daily. Dr. Dawn Ruben "Prednisone/Prednisolone" www.petplace.com/article/drug-library/library/prescription/prednisone--prednisoloneDid the vet say whether the damaged disc is in the neck or in the back?Please confirm that strict crate rest has been started. Please also confirm the date the strict crate rest was started - I assume 8/24 but please confirm. Too much movement and the damage disc can tear more, causing more pain and/or neuro damage. The less movement, the better. 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! —> www.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.jpgKnowledge is the power to fight the IVDD enemy and win!! The very best thing you can do for YOU, the caregiver, and for your dog is to get up to speed on IVDD soonest possible. Owner understanding ensures proper conservative treatment principals: ▶︎ 4 phases of healing, what it takes to heal each phase: dodgerslist.com/in-the-right-place▶︎ Roadmap for your fridge so the whole family is on board. Stay the course, avoid dangerous detours for the healing disc: www.dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdfHealing prayers for Zero. |
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Post by Terri & Zero on Sept 1, 2023 7:13:03 GMT -7
Thank you so much. I'm so glad I found this website. The vet didn't provide a lot of info and made it seem like my little guy was close to the end. I can't begin to tell you how relieved I am. I cant thank you enough for the advice and the info available on the website & forum.
Zero is on crate rest, he hates it but we're doing it. He does good until about 3 hours before his next dose of pain meds, then the shivering begins.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
15 lbs 14.5 y.0.
Prednisone as of 8/24: 2.5mgs 2x/day for 5 days, STOPPED,not tapered on 8/29
Metacam as of 8/29: 1.5mL 1x/day for 16 days, 9/13 TEST stop for: √ 8/31pain? __neuro?
gabapentin 250mg/5ml: 75mgs (1.5mL dose) ▲3x/day
Robaxin 250mg ▲3x/day
traMADol 25mgs ▲3x/day
Famotidine 10mgs 2x/day]
I just spoke [9/1] with the vet and she upped the [name of ea med?] dosing to 3x a day.
She said if we need to we can up the dose if 3x a day isn't providing enough relief.
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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 1, 2023 9:53:44 GMT -7
Terri, please let us know with the 9/1 meds adjustments, is pain now fully in control round the clock? IF not your vet need a phone call to know to further adjust. Have no patience with pain. Your vet does have room to further adjust if pain still not in control night and day. Did the vet say if the disc is in the Neck or the back?We are a bit lost in what was adjusted. Can you fill us in with dates, names of meds: Metacam (anti-inflammatory) for how many days is this to be taken? Exact detail is important to you and for us to understand the treatment.  * With any test STOP, it is always good to have worked out in advance a "PLAN B" should pain re-surface at night or on the weekend when your vet is not open. An ER visit is very expensive, a "Plan B" is free!
RULE OF THUMB on STOP of a non-steroid (NSAID) Pain surfacing= another course of Metacam + all pain meds, GI protector back on board.
No Pain= no meds at all are needed. Finish out the 8 weeks of crate rest for the disc to heal. a. What is you and your vet's PLAN B should on the TEST stop of Metacam should pain resurface? b. Which does your vet want on the Metacam STOP test day: full stop of all pain meds OR backing them down?
This page is an excellent resource for you to gain a fuller understanding the roll anti-inflammatories (steroid or non-steroid, NSAID) play during a disc episode: ==> dodgerslist.com/2020/04/18/steroids-vs-nsaids/ -- Please name the meds adjusted to 3x/day on 9/1. Pain meds last for 8hrs. Give pain meds promptly on time 3x/day! -- Confirm you ARE now giving pain meds 3x/day. -- Gabapentin What is the forumula? How many mgs in one ML of liquid?
A medication chart is useful to see patterns, have dates and specific facts handy as you discuss things with the vet. D/l a sample and a blank form to use with your dog's meds dodgerslist.com/wp-content/uploads/2020/02/med-chart-printable.pdf |
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Post by Terri & Zero on Sept 3, 2023 12:38:27 GMT -7
Zero is on meds round the clock now, every 8 hrs and is doing much better [?] .
the disc is in the back
Metacam (anti-inflammatory), he is to take this at least until his next appt.on 9/13. Vet will reevaluate him to determine next steps.
The only thing that was changed with his meds was the frequency. The vet had him at every 12 hrs but switched it to every 8 hours after I called [9/1].
[gabapentin forumula] 250mg/5ml #60cc. Give 1.5mls every 8 hours
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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 3, 2023 14:58:03 GMT -7
Terri, this is concerning your reporting pain is only "much better." When the pain meds are correctly adjusted for Zero's needs, pain ought be fully in control night and day. Tell us what is not yet right about the pain? Does pain happen at times when he has to move such as reposition in the crate. Please explain a bit more for us on what you observe and date and times it happens. Zero has fairly mild symptoms of pain only and a bit of wobbly legs. Paying attention to STRICT rest and limited movement of the back, will ensure he is able to heal the disc. And with time he can also heal the nerve damage that causes wobbly walking. Risk vs. benefitVets who know their IVDD, will adjust meds over the phone because they know a car trip into the office is a potential for too much movement of the spine.
Educated guessAll vets have to take an educated guess as to how long to use an anti-inflammatory drug. Most vets will make that guess at a 7-day course or maybe a 14-day course. Test Stop reveals the answerIt is ONLY on the STOP date of Metacam (anti-inflammatory) + the full stop or backing down on the 3 pain meds which gives the answer if another Metacam course is needed or not.
Rule of thumb with Metacam STOP
pain and/or new neuro dimishment = swelling = more time on Metacam, pain meds
and Pepcid AC needed.
At home, your jobYour job at home would be to observe for pain on the stop of Metacam +pain blocking pain meds. If pain would surface, you would alert the vet right away for another likely course of Metacam. BlindfoldsAt 9/13 vet appt, all pain meds will be on board to do their job of blocking pain. And Metacam will still be on board. It will be hard to accurately assess for pain. It takes 8 hrs for the pain meds to leave the body and it takes about 5-7 days for Metacam to leave the body. Bring up the possibility to eliminate a risky car trip in on Wed 9/13. Instead that you give phone call feedback. Especially feedback on pain + neuro function when meds have been stopped. Repair of wobbly leg nerve damage may or may not heal as fast as the disc heals in 8 weeks. |
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