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Post by lunasworriedmother on Aug 30, 2024 13:46:23 GMT -7
[Original subject line:Stage 1 Cervical IVDD ]
Hi everyone! My 20mo frenchie, Luna, was diagnosed with Grade 1 cervical IVDD yesterday, August 29th after I took her to the vet 2 hours after she woke up with full body trembling.
1 Is there still currently pain?
YES - reluctant to move much in crate such as shift positions or slow, ginger movements
YES (occasionally) - shivering, trembling
SOMETIMES - can’t find a comfortable position, appears restless
YES - Arched back
YES - nose to the ground
YES - Not they're normal perky selves?
2 How much does your dog weigh? Age?
15.6 kg, 20 months old (2 years in December 2024)
A. Currently on:
- Meloxicam 18mg every 24 hours (Aug 29) NSAID prescribed from Aug 29-Sept 12
C. PEPCID AC: If it is a short course of NSAID (ie. 14 days of meloxicam), is PPI still required?- Gabapentin (DOSE NYD - picking this up from the vet this afternoon as I advocated for it... will start Aug 30)
.[MED LIST/HISTORY- Moderator's Note. Please do not edit
34.39 lbs 20 mo old
8/29 pain, no neuro deficits
Meloxicam as of 8/29: 18mgs 1x/day for 14 days, 9/12 TEST STOP for _pain _neuro
gabapentin 100mgs 3x/day
LUNA needs GI tract protector, Pepcid AC, on board for duration of Meloxiam!
☆ 3 -- Does you dog show red flag signs of stomach damage? No
☆ 4 French bulldog, Luna. Sara
☆ 5 Was the diagnosis IVDD? Yes 🔘 -- Is the vet a general DVM? Yes
☆ 6 saw the vet for CONSERVATIVE treatment August 29
☆ 7 bladder control Yes
☆ 8 She walks without any deficits
Sorry just to add - picked up gabapentin and the dose is 100mg 2-3 [which] times a day (Aug 30).
As well, my questions are:
- I know I should avoid "sniff parties" when going out to pee/poop, but how do I practically do this when I can't force her to pee or poop on the spot?
- Are there any risks to using trazodone daily for extended periods of time (ie. weeks)?
- Because it is cervical IVDD, how do I restrict her from lifting her head up and down, or 'shaking out'?
- Any recommendations for things to keep her busy when she is feeling better - are chew toys allowed? Lick mats? Im nervous because it is cervical that anything where she lowers her head is bad for her.
Thank you so much!
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Post by Romy & Frankie on Aug 30, 2024 15:10:26 GMT -7
I just saw your second post. Thank you for registering. 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/Your Luna is in pain. Have no tolerance for pain. Pain will only slow the healing process. Please let us know frequency you actually give gabapentin. Some information about IVDD meds can be found at the page below: dodgerslist.com/meds-used-during-disc-episode/The pain of IVDD is caused by swelling of the spinal cord. An anti-inflammatory like Meloxicam works on this inflammation, but it can take as much as 30 days for the inflammation to be resolved. Medicines like gabapentin are used to control pain while the anti-inflammatory does its work. All anti-inflammatories, like Meloxicam, cause excess stomach acid. This can lead to serious stomach damage. To reduce the chances of this damage, a stomach protector like Pepcid AC is used. A stomach protector is important, even for a short course of an anti-inflammatory. The usual dose of Pepcid AC is .44 mg 30 minutes before the anti-inflammatory and thereafter every 12 hours as long as the dog is taking an anti-inflammatory. As Luna is 34.39 lbs (15.6 kgs), her dose should be 15.13 mgs. You can round this up to 20mgs. Along with meds, conservative treatment consists of 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. Carry Luna to and from the recovery suite to the potty place and then allow a very few limited footsteps. Learn about how the conservative treatment work and the importance of crate rest here : dodgerslist.com/strict-rest-recovery-process/Cervical (neck) disc issues may be more painful and can take longer to heal because the head and neck is involved with almost all movements. Extras you can do at home for a neck disc: dodgerslist.com/cervical-care-tips/What to expect for each phase of healing can be found below: www.dodgerslist.com/in-the-right-placeWe encourage you to register and become a member of the Forum. That way it will be easier for you to reply and make it easier for us to track your dog and give the best of comments and support. Tips on registering: dodgerslist.com/forum-registration/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
Medicines like gabapentin do not last long in the body and ususally must be taken 3 times daily to keep the dog pain free. If you find that the gabapentin is not enough to keep Luna pain free let the vet know right away. Luna should not be in pain.
An ex-pen in the grass helps minimize footsteps with the physical and visual to indicate there will be no sniff festing going on, Here is what that could look like: i.ibb.co/K7HNj10/slingwalk.jpg
You cannot keep her from moving her head and neck but something like raising the food and water bowl will help minimize it. You should speak to your vet about the trazadone. However, a number of our members have used trazadone during most of the crate rest period.
As an alternative to trazadone, try using these natural methods. Use any oral calmer in combination with a Pheromone diffuser. This seems to work best. It takes several days for these to start working - it isn't immediate, but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. Of course, always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price.
Place a DAP pheromone diffuser at floor level where the recovery suite is. Dogs: Adaptil (DAP) wall plug in diffuser 48ml
Use a diffuser with one oral calmer from below: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine.
Since it is a neck disk, a lick mat or kong would probably cause too much neck movement.
For entertainment :
-- During the day, try the coffee table or the dining room table, so there will be a view out a window and a better perspective on what is going on in the house from a high. -- Play classical music or one of the wildlife TV shows -- Some members have successfully used DOGTV to help calm their dog |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Aug 30, 2024 19:20:17 GMT -7
Sara, very good info Romy has for you to read in her above post. As a summary about neck disc pain, let me add: --- Most neck discs required 3 different pain meds for FULL round the clock control. --- The best pain medications control is using more than one approach to address pain from multiple fronts, each dosed 3x/day (every 8 hrs) -- traMADol-general analgesic every 8 hrs -- methocarbamol- muscle spasm pain so very typical to a neck disc every 8 hrs -- gabapentin-nerve pain) every 8 hrs
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.
Alert the vet to get meds adjusted, you are his eyes and ears to know if adjusting is needed.
Thank you for registering!
Please do login to post to let us know if Luna is now fully out of pain with adjustments to her pain meds (name of each: ?mg ?x/day) |
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Post by Sara & Luna on Aug 31, 2024 6:43:52 GMT -7
Thank you so much for all the amazing advice!!!
Our current regimen is:
- Meloxicam 18mg 1x daily (Aug 29)
- Gabapentin 100mg 3x daily (Aug 30) - she just got her third dose of it this morning.
After the gabapentin first dose on Aug 30, she seemed like a brand new dog! She was totally back to her normal self. No arched back, nose to the ground, shivering or whimpering. She did wake up this morning seeming a bit more 'stiff' to me so I will keep an eye on that.
We have her in strict pen rest and now the hardest part is differentiating her whines of boredom from whines of pain (I do think they are all boredom whines now though).
We have generic famotidine at home - just to confirm it is okay to give this to Luna even though it is 'human' formulated? Just a regular tablet.
Also, how long do most dogs need the gabapentin for? I think ours is enough for 2 weeks but I was reading some dogs need it for 4 or even 6. Does it require a medicine taper?
Thanks so much again,
Sara
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Aug 31, 2024 12:20:51 GMT -7
Sara, what country are you in? Glad to hear only one pain med (gabapentin for nerve pain) is providing dose to right up to next dose, round the clock pain control. If it is not, then speak up, advocate for all sources of pain to be covered.
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 The generic product should contain only one active ingredient: famotidine. Confirm the dose in mgs and that you give it every 12 hrs (2x/day). No one knows how long it will take for Meloxicam to resolve all painful swelling. Untill you have observational proof all pain is gone, pain meds must be in use, PROOF of painful swelling statusMeloxicam as of 8/29: 18mgs 1x/day for 14 days, 9/12 TEST STOP for _pain _neuroThe 14-day course of Meloxicam is scheduled to STOP on Sep 12. That is the day you will be observing for pain. Alerting the vet if pain surfaces and expecting another course of Meloxicam, pain meds, famotidine. It can take in the range of 7 to 30 days to get the swellling resolved. It may take one course or several adding up the typical 7-30 days of the anti-inflammatory Meloxicam.
Let us know if gabapentin will also be stopped on Sep 12 so that you are not blindfolded to the reality of pain or no pain. Read up on gabapentin at Mar Vista Vet Directory. Usually is tapered with dogs having history of siezures. Do discuss with your vet and let us knowAnti-inflammatories remedy pain by reducing inflammation.
Rule of thumb on TEST STOP of Meloxicam: pain = swelling= another course of Meloxicam + all pain meds, Pepcid AC back on board. NOTE: Always have a plan B in place with the vet prior to the stop of Meloxicam on what you should do should pain surface. Have enough meds on hand til the vet reopens, an Rx that could be filled at your local 24hr pharmacy?? Should pain re-surface over a weekend or evening when the Vet is closed, a plan B is free and an ER visit is expensive. Source article: ==> dodgerslist.com/steroids-vs-nsaids/ |
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Post by Sara & Luna on Sept 3, 2024 7:51:34 GMT -7
Hi all! Lunas current meds: - ✙ Famotidine 20mg twice daily - Meloxicam 18mg once daily - Gabapentin 100mg 3x daily - Trazodone as needed We will stop gabapentin September 12 to see how she is doing without pain meds on board and then reassess. We live in Canada!
[MED LIST/HISTORY- Moderator's Note. Please do not edit
34.39 lbs 20 mo old
8/29 pain, no neuro deficits
Meloxicam as of 8/29: 18mgs 1x/day for 14 days, 9/12 TEST STOP for _pain _neuro
gabapentin 100mgs 3x/day, stop on 9/12
Trazadone as needed
✙famotidine 20mg 2x/day]
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Post by Sara & Luna on Sept 6, 2024 7:03:26 GMT -7
An update about Luna...
Since last night (Sept 5) she has had 4 episodes of vomiting - 8pm, 1am, 9:30am, and now 10am. [reported days later: "as the day she had been vomiting she had other confounding factors at play (my family had come to visit her/she had more trazodone/more treats)."]
She does not seem to be in pain but does seem to be feeling unwell (whale eyes, laying around mostly). However, before she got her 8am trazodone she was very alert, happy! She has not missed any doses of her famotidine, and her last dose of meloxicam was 1900h [9/4] last night with her food. She still has a good appetite despite this (she'll try to eat her vomit...) but obviously it's unusual. Her vomit looks like undigested food.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
34.39 lbs 20 mo old
8/29 pain, no neuro deficits
Meloxicam as of 8/29: 18mgs 1x/day for 14 days, 9/12 TEST STOP for _pain _neuro
as of 9/5 STOP NSAID now 9-day course reduced to due to vomit
gabapentin 100mgs 3x/day, stop on 9/12
Trazadone as needed
famotidine 20mg 2x/day]
I called my vet, who suggested that since she doesn't seem to be in pain, we discontinue her NSAID and continue her gabapentin and see how she does. I am nervous in doing that - one because Im worried the gaba will mask any pain, and two because her NSAID is only the really thing 'treating' the underlying problem. Her next dose of NSAID was supposed to be in about 9 hours.
Do you have any advice?!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Sept 6, 2024 8:44:58 GMT -7
Sara, discuss the merits of these ideas: 1. Instead of the original 14-day Meloxicam course, the stop on 9/6 makes it a 9-day course. No one really knows how long a course is needed. Often vets will try a 7-day or a 14-day course. ONLY the Meloxicam stop AND the gabapentin stop give proof if all swelling is really gone. Discuss stopping gabapentin now so the test for any surfacing pain can be correctly monitored by you at home. 2. If the vet believes the 14-day Meloxicam course is a must to complete, then try double protecting the stomach with not only the famotine to suppress acids but also by adding in a 2nd protector called sucralfate which would form a gel coating over any damaged areas of the stomach lining. 3. There are some few dogs where famotidine just does not sit well with them causing them to vomit. Luna just started famotidine on 9/3. Those dogs sensitive to famotidine should take a different acid suppressor while on Meloxicam to prevent these progressive signs of stomach damage: lip licking due to nausea, not eating, vomit, loose stool, bleeding ulcers red or black blood in diarrhea, ulcers/perforated stomach lining. Keep us posted on Luna and what your vet says. |
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Post by Sara & Luna on Sept 7, 2024 9:14:48 GMT -7
Good morning!
We opted to go with option #1, (Sept 6) stopping the meloxicam and the gabapentin
She was fine until about 15 hours post gabapentin [on 9/7), she was reluctant to move, keeping her nose to the ground.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
34.39 lbs 20 mo old
8/29 pain, no neuro deficits
Meloxicam as of 8/29: 18mgs 1x/day for 14 days, 9/12 TEST STOP for _pain _neuro
as of 9/6: STOP NSAID now 9-day course reduced to due to vomit; √9/7 pain
✙gabapentin 100mgs 3x/day, (9/6 had stopped- pain surfaced 15hrs later)
Trazadone as needed
famotidine 20mg 2x/day]
We decided to give her ✙gabapentin then before bed, and she woke up this morning (Sept 7) fine, about 12 hours after the dose, with no symptoms of pain.
I spoke to the vet tech this morning, who said to continue with gabapentin as needed for pain and stay off of the NSAID (she will confirm with the vet and get back to us).
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Sept 7, 2024 10:48:36 GMT -7
Sara, it appears your test stop of pain med and NSAID revealed painful swelling still exists. Not unusual, as it can take in the range of 7 to 30 days before the NSAID can fully resolve pain. Has Luna continued to take famotidine? Any signs of vomit? Let us know the details. Dogs might tolerate one brand of NSAID over another. It takes about 5-7 days after stopping the NSAID before it fully leaves the body. So should a vet decide to try a different brand, it can be done. The 5-7 days of washout can be dispensed with if the stomach is double protected when there would be days of the old and the new NSAID are both in the body. When the vet deems it an emergency to get a NSAID back on board to deal with painful swelling, that double protection is: Sucralfate PLUS famotidine (or another acid suppressor) on board. Do read about sucralfate in advance so you are aware of the timing with food, with an acid suppressor. **  |
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Post by Sara & Luna on Sept 7, 2024 10:58:57 GMT -7
We stopped the famotidine with the discontinuation of NSAID and gabapentin on Sept 6.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
34.39 lbs 20 mo old
8/29 pain, no neuro deficits
Meloxicam as of 8/29: 18mgs 1x/day for 9 days, 9/6 STOP √9/7 pain
as of 9/8 : 18mgs 1x/day for 5 days, 9/14 test SToP for__ pain
gabapentin 100mgs 3x/day, (9/6 had stopped- pain surfaced 15hrs later; 9/8 gabapentin restarted 9/8, Stopped on 9/14)
Trazadone as needed
famotidine 20mg 2x/day stopped 9/6]
No vomiting since then and she has full appetite and interest in food, bowel movements are normal.
It seems for now the vet would like us to stay off the NSAID, and
continue with gabapentin just to manage the mild pain symptoms.
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Post by Romy & Frankie on Sept 7, 2024 13:10:56 GMT -7
I am happy to hear that Luna is not vomiting and is interested in her food. All good news.
The existence of pain during an IVDD episode indicates that swelling of the spinal cord still exists. With the stop of meloxicam, nothing is working to reduce this swelling. If you see any worsening of pain, please let the vet know right away. You could discuss with your vet if it is possible for Luna to safely start on a different anti-inflammatory with the addition of sucralfate to the Pepcid AC.
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Post by Sara & Luna on Sept 14, 2024 10:33:36 GMT -7
Update for Luna! We had stopped the NSAID + gaba for 24 hours (from Sept 6-7) and noted the increased pain at about the 15 hour mark. The next day, Sept 8, we actually opted to restart the NSAID with discussion with our vet, as the day she had been vomiting she had other confounding factors at play (my family had come to visit her/she had more trazodone/more treats). Excitingly, she did absolutely fine with reintroducing the meloxicam (no vomiting, great appetite) on September 8th and we were able to finish her two week course yesterday morning, September 13th! So far, it has been 24 hours since any gabapentin or meloxicam and she has no signs of pain or discomfort. Of course, we'll continue to watch closely over the next few days and she remains in strict crate rest  |
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Post by Romy & Frankie on Sept 14, 2024 13:00:42 GMT -7
This is wonderful news. I am glad that you are watching carefully in case pain returns.
Now Luna can relax and continue recovering in her crate.
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Post by Sara & Luna on Sept 18, 2024 5:46:18 GMT -7
Good morning! Unfortunately Luna has had increased urinary frequency (smaller volumes) with urgency ( peeing in her crate) over the last 24 hours, and last night started to have blood in her urine (both small 1-2mm blood clots and just bright red blood). While she is eating an drinking fine, she does seem to be uncomfortable but this seems much more related to her voiding ( scooting her bum etc). We called her vet and she is going to be seen this morning. I was wondering if you have seen this happen with other IVDD dogs? She has remained continent this whole time and kept up with her usual potty routine so Im not sure if it's just being more sedentary or what that provoked this. If it is a UTI, any advice on how I can prevent more of these in the future? I appreciate any advice |
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Post by Romy & Frankie on Sept 18, 2024 13:24:44 GMT -7
It sounds very much like a urinary tract infection. Although dogs with and without IVDD can get urinary tract infections, it is more common in our IVDD dogs.
The one thing that stands out to me is that you mentioned it seems related to voiding. Scooting her bum on the ground may be helping bacteria to enter her body. Females have a very short path into the bladder, and bacteria from the ground or even a tiny bit of feces can get into the bladder and result in a UTI.
The vet's office will likely do a urinalysis to check if there's infection. A urinalysis will show if there is bacteria in the urine, although it doesn't identify the bacteria. If bacteria is noted, a broad-spectrum antibiotic will be prescribed.
You can speak with your vet about cranberry supplements. This will not cure an infection, but it may have some preventative effect. |
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