|
|
Post by Nick & Hank on Apr 10, 2024 14:49:13 GMT -7
[Orig subject: Hank; 7 yo black lab; calcified disc in neck]
Hello, my dog Hank was diagnosed with a calcified disc in his neck after going to the emergency vet on 4/3/24, with x-rays done on 4/4/24. We decided on the conservative route, and limited his mobility at first, but with kids quickly realized he needed to be isolated, where we blocked off a hallway for him to relax. He’s on gabapentin and a muscle relaxer.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
95 lbs 7y.o.
Novox 4/1: 100mgs 2x/day for ? days, then a test taper for: _pain / _neuro
gabapentin 600mg 2x/day
Robaxin 500mgs ?x/day
Amantadine 100 mg: 200mg 1x/days
Hank needs GI tract protector, Pepcid AC, on board for duration of Novox! ]
Sunday we really started the isolation, where he seems to be doing well on the drug moving around to go pee / poop, he has full function there. About 10 or 11 hours into the gabapentin, it seems to wear off and he gets shaky / in pain. This is our first time dealing with anything like this and we feel so bad for him, worry that he’ll be like this forever, just looking for what to expect during the healing process. He hasn’t had any major yelps since isolation, but you can tell he’s still in pain when the meds wear off. Is there a point where you see progress and can start backing off the meds while keeping in isolation? Are the first few weeks the worst for dog and dog owner? Thanks!
Sorry, just registered and saw the questions. Hank weight about 95 pounds, eats, drinks, pees and poops “normal” albeit a little slower than normal. He has full movement of all Limbs but when he’s in pain he’s shaky in the front right leg, signs when in most pain would be stiff neck, hunched back. As he’s almost 100 lbs we can’t carry him outside so we slowly walk him on a harness, I built a ramp for our stairs where we walk out to pee / poop then head back in. He’s a low energy lab who likes his sleep so when he’s isolated, he lays there most of the day.
Thanks!
|
|
|
|
Post by Romy & Frankie on Apr 10, 2024 15:13:26 GMT -7
Welcome to Dodgerslist. We are glad you’ve joined us all. We’ve got valuable information we’ve learned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you! Learn more about us and how we team up with veterinarians: dodgerslist.com/about-team-dodgerslist/
The most important thing you can do for Hank right now is to start Very Stict crate rest. The importance of crate rest can be compared to the importance of a cast for a broken arm. The cast immobilizes the arm, allowing the broken bone to heal. The crate is like the cast, immobilizing the spine and allowing the disc to heal.
The crate rest during conservative treatment must be very strict. STRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times.
If you can, carry Hank to and from the recovery suite to the potty place and then allow a very few limited footsteps. With a lab, it is unlikely that he can be carried, so another way to limit footsteps during pottying is important. One thing you can do is use a pee pad right outside the crate. Your dog may be reluctant to use the pad. If so, get a newspaper or paper towel with either his own or another dog's urine on it and place it on the pad. This will encourage the dog to use the pad. I did this with my dog, Frankie, during his disc episode.
Another thing you could try is to put caster wheels on a wire crate and simply move the crate as close to the door as you can. The goal with both these methods is to limit the amount of footsteps taken.
The crate should only be large enough to allow the dog to stand up, turn around and fully stretch out when lying down.
Information about crate rest and tips for setting it up can be found at the link below: www.dodgerslist.com/2020/05/14/strict-rest-recovery-procYou didn't mention an anti-inflammatory. During a disc episode, an anti-inflammatory is almost always prescribed. The pain and any neuro deficits like trouble walking are caused by inflammation of the nerves of the spinal cord. The anti-inflammatory will work on this inflammation, so it is very important. If your dog has not been prescribed an anti-inflammatory, either a steroid or an NSAID, please ask the vet about this right away . While the anti-inflammatory is doing its work, pain relievers are prescribed. It can take between 7–30 days for the inflammation to be reduced. Gabapentin and muscle relaxers are good pain relievers during a disc episode. But these meds do not last long in the body and often must be prescribed 3x a day to provide full relief. Since your dog is showing signs of pain when the meds wear off, please call the vet right away, tell her what you are seeing and advocate for the meds to be prescribed 3x a day. Pain will only slow the healing process.
Information about meds used during a disc episode can be found at the link below. dodgerslist.com/meds-used-during-disc-episode
Please list the exact names of all meds currently given, their doses in mgs and times per day given.
During an IVDD episode, the dog is at risk of stomach damage caused by excess stomach acid. This is because of stress caused by pain and bodily changes. This risk is particularly high when a dog is on anti-inflammatories. To lower the risk of stomach damage, a stomach protector like Pepcid AC is used. Ask the vet if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). The usual dose of Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory.
Here is what to expect for each phase of healing: www.dodgerslist.com/in-the-right-place
Is your name Nick? I am Romy.
We encourage you to register and set up email alerts as timely interaction/communications is needed when helping Hank. How to register and how to do the email alerts here: www.dodgerslist.boards.net/thread/7353/register-bookmark-dogs-post-thread
It is very scary when our dogs have IVDD. It becomes less so when we learn all we can about the disease. More information can be found at our main website: www.dodgerslist.com |
|
|
|
Post by Nick & Hank on Apr 10, 2024 15:35:01 GMT -7
Yes, I’m Nick, nice to meet you virtually. I am on the road traveling right now but here are the 4 medications that have been prescribed -
Amantadine - 100 mg 2 pills every 24 hours
Novox - 100 mg every 12 hours
Robaxin - 500 mg every 8-12 hours
Gabapentin - 600 mg every 12 hours
Novox is the anti inflammatory that I forgot. I sent a secondary post that I think answers most everything else once I registered. He’s been handling the medication pretty well, although when peeing outside will nibble at grass.
|
|
PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,562
|
Post by PaulaM on Apr 10, 2024 20:24:10 GMT -7
Nick, if you are still seeing the pain meds wear off too soon, and Hank is in pain, then phone in your observations. Look for these adjustments to his meds: Novox might take anywhere in the neighborhood of 7-30 days to resolve all painful swelling.
Each of the pain meds are effective for 8 hours. Each target a different kind of pain. This is why those who know their IVDD, Rx them for promptly every 8 hrs (3x/day).
🚩 traMADol-a synthetic opioid as the general analgesic. Every 8 hrs. 🚩 Robaxin (methocarbamol)- muscle spasm pain. It should be also Rx for every 8 hrs. 🚩 gabapentin-nerve pain). Should also be Rx'd every 8 hrs. 🚩 Amantadine is not a pain med per se. Neuro surgeons are finding success by adding it to the above 3-way pain med combo as it allows other those analgesics to function more effectively. Mar Vista vets explain the mysteries of amantadine www.marvistavet.com/amantadine.pml 🚩Advocate plus a stomach protector such as Pepcid AC (Famotidine) to protect against the side effects of the anti-inflammatory Novox.
Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach.
Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health issues” answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine).
--The dose of famotidine may require reduction in patients with liver or kidney disease.
-- It may be prudent with heart patients to choose another class of acid reducer.
Adjusting meds by phone avoids a risky-to-the disc car transport especially with a large dog! Describe the pain that you're seeing to get the meds adjusted. 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, interested in life 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 Here is the recommended way to make a reply. ➡️ QUICK REPLY: Easy, fast and recommended! Go to the " Quick reply" typing area at bottom of your dog's thread to write a reply. Quick Reply allows scrolling up to a previous post & back down to the "Quick Reply" typing area to continue your own post.
|
|
|
|
Post by Nick & Hank on Apr 10, 2024 21:11:01 GMT -7
Thanks Paula for the info. I will contact the vet about adjusting med times as I think that would completely eliminate any of his uncomfortable episodes when the meds wear off..
In terms of his rest area, we have blocked off a small L shaped hallway for him. We have 2 young active kids and don’t have the space for a gated area, and he won’t go full crate. So we’ve gated off this hallway with some blankets for comfort, his food and water are both raised to help with discomfort. It’s a short walk to our front door and down the ramp for him to use the bathroom (again, too heavy to carry). He’s a low energy dog so he sleeps most of the time. He does get excited when we get home from
Work, which I think leads to his discomfort with the medicine wearing off (excitement is tail wagging, not jumping or anything like that). He used to be free range in the house and would sleep on our bed most of the day while we were at work, using the gate now has prevented him from jumping on any furniture. It’s not the “small space” recommended but he mostly lays in the same spot and doesn’t move much at all.
Thanks!
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,562
|
Post by PaulaM on Apr 11, 2024 8:24:25 GMT -7
Nick, see what is possible with your situation and resources to give Hank every chance possible to heal his disc and not re-damage what's healed so far. A relapse to disc healing due to too much walking could then cause damage/diminishment to the nerves. (wobbly walking, loss of bladder control, permanently paralyzed legs). The idea with STRICT limited movement is to keep mild symptoms mild. To avoid a surgery, to prevent the disc from severely moving to spinal cord damage. Recovery suite area sizeThe size of the recovery suite, ex-pen, etc. should only be big enough to stand on all four legs, to easily turn around and when lying down to fully stretch out legs. •The recovery suite area should NOT be big enough to include a full time separate toilet area. •Measurements would be approximately as wide as the dog’s head to tail length by 1.5 times the dog’s length. •Pad out any extra room in the suite with a rolled up blanket as kind of a bolster to deter walking around in the designated suite area. A bolster makes a nice head rest especially that neck dogs might choose to use. •Use a wire suite (rather than plastic or canvas) for a less visually isolating feeling. • POTTYTIME from the suite should only allow a few minimal footsteps. Since you can't carry him, set up an expandable adjacent area potty place. . No more short walks anywhere! Only a few footsteps for Hank to get to a pee pad to do his business as you unfold some panels to give access to pee pad. • Save some of his old urine on a piece of paper towel. Refrigerate in a ziplock bag. At potty time place urine stained piece on the pee pad as incentive to pee. Hank can be trained to know you approve of only peeing in the house on the pee pad. When you see him show interest/sniff, tell him "go potty." Soon he will get the idea and may even potty on your command! If an 8-pan ex-pen is an option. Ex-pens can be configured in numerous ways to meet needs such as unfolding panels when it is time to use for potty time pee pad. The video below shows you one idea of flexiblity of an ex-pen. All dogs do the unexpected. Might be a door knock, something floating by the window a TV doorbell, that causes them to attempt to bolt, dart. Our job is to be one step ahead in providing the full safety of a recovery suite for our healing member of the family. An option could be several "gates" like the one you currently have hinged together with tie wraps to make your own ex-pen. Do let us know what the med adjustments are (mgs, times per day). Hank sure does deserve to heal in comfort from pain. It is not unusual for owners to report signs of pain where the vet can further tweak his prescriptions. |
|
|
|
Post by Nick & Hank on Apr 11, 2024 13:57:48 GMT -7
Thanks, we’ll shorten up his space a bit to limit his movement even more. Is it uncommon for him to yelp in pain during the first few weeks? We shorted the ▲gabapentin to every 8 hours and the▲ muscle relaxer.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
95 lbs 7y.o.
Novox as of 4/1: 100mgs 2x/day for12 days, 4/11 test STOP for: √4/10 pain / _neuro
as of ?: 100mgs 2x/day for 14 days, then 4/27 STOP for _pain/_neuro
gabapentin 600mg ▲3x/day
Robaxin 500mgs ▲3x/day
Amantadine 100 mg: 200mg 1x/days
Hank needs GI tract protector, Pepcid AC, on board for duration of Novox! ]
He was just sitting there and yelped out and started to have a muscle spasm, and was about 30-40 minutes since we gave him the muscle relaxer. I know we don’t “want” any pain, we just feel so helpless and wonder if it’s part of the healing process or if that completely shouldn’t happen? Thanks!
|
|
|
|
Post by Romy & Frankie on Apr 11, 2024 14:30:25 GMT -7
That type of pain should completely not happen. Since you are seeing signs of pain shortly after giving Hank the muscle relaxer, the pain meds are not yet right. It may be possible to increase the dosage of the Robaxin (methocarbamol). In this article, written by Dr. Dawn Ruben, the dosage of methocarbamol is discussed; "Initially, methocarbamol is dosed at 7 to 20 mg per pound (15 to 44 mg/kg) up to three times daily. The dose of methocarbamol should not exceed 150 mg per pound (300 mg/kg) per day."
This article should be used only as a basis for discussion with your vet. Your vet knows Hank's medical history and will be able to advise you if an increase in dosage is appropriate.
Another medication that we see commonly prescribed during a disc episode is tramadol as a general pain reliever. Tramadol works very well when used along with gabapentin. You can also discuss this medication with your vet.
Hank should not be in pain. Pain only slows the healing process.
|
|
|
|
Post by Nick & Hank on Apr 11, 2024 14:49:44 GMT -7
Thank you!
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,562
|
Post by PaulaM on Apr 11, 2024 16:12:10 GMT -7
Nick, be sure it is NOT you who is adjusting the meds in a way not prescribed on the bottle. Phone the vet, get new instructions as to mgs and times per day.
We are at a disadvantage to comment without a good med list from you.
What does the bottle read on the Novax?
Date started? And for how many days?
Adjusting meds by phone avoids a risky-to-the disc car transport especially with a large dog! Describe the pain that you're seeing over the phone to get the meds adjusted.
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.
There are often three sources of pain with a disc episode. Hank only has 2 of the 3 sources of addressed! Advocate for traMADol 3x/day. Yesterday's post gives you the information so as to know what to expect. Scroll back up to read about 🚩traMADol
|
|
|
|
Post by Nick & Hank on Apr 12, 2024 6:52:48 GMT -7
Yes, I’ve got a close relationship with my vet, I haven’t updated any medication without his approval. Thank you all for the advice, we’ve made some tweaks which we hope bares some success!
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,562
|
Post by PaulaM on Apr 12, 2024 7:04:39 GMT -7
For how many days is the Novox Rx? This IS important information to have.
What does the bottle read on the Novax?
Date started? And for how many days?
|
|
|
|
Post by Nick & Hank on Apr 12, 2024 7:13:35 GMT -7
We started on 4/1 with it (before it got worse on 4/3), I’m away from home and don’t have the bottle in front of me, but they just refilled it for us, so I’d we’re on day 11 of it now, with another 10 days or so of prescription. The bottle doesn’t say for how long unfortunately
[MED LIST/HISTORY- Moderator's Note. Please do not edit
95 lbs 7y.o.
Novox as of 4/1: 100mgs 2x/day for12 days, 4/11 test STOP for: √4/10 pain / _neuro
as of ?: 100mgs 2x/day for 14 days, then 4/27 STOP for _pain/_neuro
gabapentin 600mg 3x/day
Robaxin 500mgs 3x/day
Amantadine 100 mg: 200mg 1x/days
Hank needs GI tract protector, Pepcid AC, on board for duration of Novox! ]
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,562
|
Post by PaulaM on Apr 12, 2024 8:06:13 GMT -7
Nick, we and you should be VERY aware and interested in the date to stop Novox on each Novox course including this lastest refill. The stop date means you are to be observing for any pain and quickly report to vet. Pain would indicate not enough time on Novox. Expect another course of Novox. It can take a total of several courses adding up to 7-30 days for Novox to fully resolve painful inflammation. Rule of thumb with Novox, the anti-inflammatoryOn NSAID stop date, stop pain meds so there is an accurate read if pain still exists. Some vets prefer instead (depending on dog) to back off on all pain meds. You ought to know ahead of time which method full stop pain meds or back down mgs and/or times per day. Rule of thumb On NSAID stop date watch for any hint of pain surfacing: pain = swelling = another course of Novox
+ pain meds, Pepcid AC back on board.
No pain = no meds at all are needed.
Complete the balance of 8 weeks of crate rest
to allow the disc to heal.
Nick when you are back home, do fill us in on the Novox. 1. What date was the Novox refill on?
2. For how many days worth are those pills at 100mgs 2x/day?
3. On the stop date for current Novox refill, will all pain meds be full stopped or back down to allow an accurate read on pain?
|
|
|
|
Post by Nick & Hank on Apr 15, 2024 6:09:22 GMT -7
Hi Paula,
Back in town now. We have [as of 4/15] 10.5 days of novox remaining, we began it on April 1st before he got worse, so April 27th is the end [Novox course] of it for now. In speaking with the vet, we will continue with this script in the hopes of weening hank off the pain pills towards the end [of Novox course] , as you mentioned to get a pulse on his pain / progress.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
95 lbs 7y.o.
Novox as of 4/1: 100mgs 2x/day for12 days, 4/11 test STOP for: √4/10 pain / _neuro
as of ?: 100mgs 2x/day for 14 days, 4/27 STOP for _pain/_neuro
gabapentin 600mg 3x/day back off nearing 4/27 Novox STOP
Robaxin 500mgs 3x/day back off nearing 4/27 Novox STOP
Amantadine 100 mg: 200mg 1x/days
Hank needs GI tract protector, Pepcid AC, on board for duration of Novox! ]
We [4/11] adjusted his gabapentin timing, and have had good results with that thus far. Saturday and Sunday were good days for Hank, with no episodes of pain or anything like that, so we’re hopefully he’s starting his healing journey! Again, I really appreciate the support, and a consistent voice has helped tremendously!
Nick
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,562
|
Post by PaulaM on Apr 15, 2024 8:03:39 GMT -7
Nick, glad to hear that the April 11th increase of Robaxin 500mgs and gabapentin 600mgs both increased to 3x/day is keeping Hank pain free round the clock.
|
|
