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Post by Lisacan on Oct 13, 2024 15:02:02 GMT -7
  [Original subject line:Boston Terrier Lulu ] QUESTIONS ☆ 1 Is there still currently pain? X reluctant to move much in crate such as shift positions or slow, ginger movements
X yelping when picked up or moved
☐can’t find a comfortable position, appears restless
X Arched back X head held high or nose to the ground
X Holding front or back leg flamingo style not wanting to bear weight Full pain relief is expected in1 hour and stays that way dose to dose.
If not in control your vet needs to know asap to adjust meds.★2 25lbs possibly 12 years old Gabapentin 100mg every 8-12 hours Methocarbamol 500mg; 250mg every 8 hours Predisone start date 10/10/24: 10mg; 5mg every 12 hours for 1 week with food; then once daily for 1 week then every other day until gone Trazodone 50mg - 1 50mg tablet every 8-24 hours for anxiety during crate rest [MED LIST/HISTORY- Moderator's Note. Please do not edit
25lbs 12 y.o.
10/8 high liver enzymes, reason for no anti-inflammatory Rx
10/10 wobbly walk; knuckles and corrects front paws
Prednisone as of 10/10: 5mg 2x/day for 7 days; Sun 10/20 TEST TAPER for: _ pain and _neuro
gabapentin 100 mgs 2x/day
methocarbamol 250mgs 3x/day
traZODone 50mgs ?x/day
Lulu needs GI tract protector, Pepcid AC, on board for duration of prednisone! ] C.. PEPCID AC: Phrase a simple question that you expect a simple "yes "or "no" to it. Does my dog have 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).
(NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. www.1800petmeds.com/Famotidine-prod11171.html ) ------
☆ 3 -- Does you dog show red flag signs of stomach damage? Avoid confusion... list only those you actually observe:
Not eating? vomit? loose stool? bleeding ulcers? red or black blood in diarrhea? ☆ 4 Boston Terrier, Lulu. Lisa ☆ 5 🔘 She is being t reated for Grade 2 IVDD; ACVM Neurology ☆ 6 🔘 What was the date you saw the vet for CONSERVATIVE treatment? 10/10/2024 Super tried and true tips for setting up the recovery suite, the mattress and more! —> dodgerslist.com/strict-rest-recovery-process/ STRICT means:
- no laps - no couches
- no baths - no sleeping with you
- no dragging or meandering at potty times.
- no PT - no chiro therapy
Why Chiropractic is not recommended for pain for an IVDD dog: dodgerslist.com/chiropractic/ )☆ 7 🔘 Yes squats to urinate; stands to defecate DOGs with BLADDER 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 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!☆ 8 Can wobbly walk knuckles front paws |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Oct 13, 2024 17:40:34 GMT -7
Lisa, you have indicated with an X that currently Lulu is experiencing many signs of pain. Lulu should be able to heal in comfort. Have no patience with pain as it can hinder the healing process. There should be NO pain dose to dose of pain meds, night and day. You have a pain emergency to call 10/13 now and get the meds adjusted over the phone. The vet on duty where you saw the neuro can access Lulu's file and make adjustments over the phone. This avoids a dangerous car transport with the potential of too much movement for the healing disc. Let us know what adjustments the vet made: name of med, ?mg ?x/day.Gabapentin should be given every 8 hrs because that is how long it is effective. Confirm if you had been giving every 12 hrs and that you now are giving every 8 hrs. Confirm Pepcid AC (famotidine), an acid suppressor is now on board. ?mg ?x/day Good reading to understand why you have asked if there are any health issues and if none, that you have it on board:
🚩 3 Reasons why Pepcid AC: dodgerslist.com/stomach-protection/🚩 Pepcid AC (famotidine) drug information: marvistavet.com/famotidine.pmlDid the Neuro say that she has a neck disc? With front legs affected, that is a sign of a neck disc. Are the back legs also wobbly or just front legs wobbly? There are extra things you can do at home to help the neck heal, such as softening hard kibble, raising food/water dishes, etc. More info here: 🚩 dodgerslist.com/cervical-care-tips/When things are in order for Lulu, please do register. Thank you in advance. |
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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 14, 2024 5:31:32 GMT -7
I will contact the veterinarian and review Lulus meds. Yesterday [10/14]was a day where she yelped a few times. Once she layed down she was comfortable the whole night.
After Lulu saw the regular Vet on 10/8, she was prescribed ▲gabapentin 50mg and dosage was every 8-12 hours. I gave her first dosage when we got home and waited the 12 hours to give her another 50mg. She is now [as of 10/12] on an▲8 hour schedule of 100mg.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
25lbs 12 y.o.
10/10 wobbly walk; knuckles front paws
Prednisone as of 10/10: 5mg 2x/day for 7 days; Sun 10/20 TEST TAPER for: _ pain and _neuro
gabapentin ▲100 mgs ▲3x/day as of 10/12
methocarbamol 250mgs 3x/day
traZODone 50mgs ?x/day
Lulu needs GI tract protector, Pepcid AC, on board for duration of prednisone! ]
I will check with the Vet to make sure there is no reason why Lulu cannot take Pepcid AC before giving it to her
When you say neck disc, is this IVDD? The neurologist gave me a sheet on this disease.
The Neuro Vet drew a diagram indicating what can be causing Lulu's pain which included Myelopathy, disc disease, tumor, inflammatory.
The drs. report noted forebrain dysfunction due to her circling at the office (her primary vet said she circled right at the office on 10/8). Lulu was not right circling at home after this happened suddenly to her on 10/6. Two days ago when we brought her outside she circled both ways to urinate and defecate. I believe this is due to where her neck pain is, in my opinion.
Just her front legs are wobbly. I also took some videos of Lulu after this happened to her. I could see she was able to move around and appeared somewhat wobbly. But she then would sit down right away. We just thought she injured herself.
I have been feeding Lulu canned food by hand everyday as she is not standing up in her crate. I also been giving her water through a syringe many times throughout the day and also add water to her food. I got a water bottle yesterday that hangs in her crate. She has not used it yet.
Her bed does take up all the room in her crate. With her not standing up to move around i wasn’t sure if I should change her set up right now. I didnt want to risk her falling. We are carrying Lulu outside 2-3 times a day. She hadn’t yelped out as much previous to yesterday. Should she not be yelping out at all with the right dosage of medications.
We try to be extremely careful when lifting her and putting her back in her crate. Her crate is enclosed but has a front door and my husband places her back in very gently. Thank you!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Oct 14, 2024 8:07:44 GMT -7
Lisa, any pain is TOO much pain. You are the eyes and ears for the vet to know if he needs to adjust pain. Accurately reporting using dates, observations, dose times and amts, etc. is the best way to communicate. MEDICATION CHART- A medication chart is useful to see patterns, have dates and specific facts handy as you discuss things with the vet. Useful tool for quality communications with your vet. D/l a sample and the blank form to use with Lulu's meds 🚩 dodgerslist.com/wp-content/uploads/2023/12/med-chart-printable.pdfUpdate us on signs of pain you see re: the adjustment to gabapentin you made Sun 10/14(?). In your post only list the pain signs you observe with this current gabapentin at 100mgs 3x/day
SIGNS OF PAIN with an IVDD disc episode: ⚙︎ 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 ➕signs with 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
There should be no signs of pain from one dose of meds right up to the next dose. There should be no signs of pain nearing the next dose. Pain meds last for 8 hrs.
Monitoring Neuro signs for your vet
Clarify.
-- Can she no longer rise up into a stand with front legs?
-- Or is she still able to sit on her butt by raising her front legs but just does not do that often? Does she use her front legs to help reposition herself in the suite?
MONITORING NEURO FUNCTIONS at home for the vet
Nerves do heal in the exact opposite order nerve damage occured.
1. 10/10 Pain with initial tear of disc and ensuing swelling
2. 10/10 Wobbly walking front legs
_?_front legs cross, __ Rear legs?
3. _?_front paws: Nails/toes scuffing floor
4. _?_Paws knuckle under. Dog is slow to correct or can't right the paw(s) at all
5. _?_Weak/little leg movement with front or rear legs.
? can't move up into a stand with front legs
6. __Front or rear legs do not work at all (paralysis, dog is down)
7. __Bladder control is lost. Leaks on you when lifted.
Can no longer sniff and then pee on that old urine spot outdoors.
8. __Tail wagging with joy is lost with specific happy talking
9. __Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy.
Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance.
Learn about Prednisone.
An informed owner is a dog's best defense when taking an anti-inflammatory.
--Know what your job is when the pred taper begins on Sun 10/20
--how to arrange in advance for a Plan B with your vet should pain surface on Sunday or at any point in the taper doses for prednisone. -- Understand the roll of the anti-inflammatory prednisone: 🚩 dodgerslist.com/steroids-vs-nsaids/Let us know what you and your vet have arranged for the Plan B. --- Let us know if on Sun 10/20 if all pain meds will be stopped or backed down as well so that you are able to quickly and accurately detect if pain begins to surface. Pain meds on board with a pred taper blindfold you to being able to observe pain. --- What is the Plan B? Extra meds on board or an Rx you can fill at a 24hrs local pharmacy? Lisa would you be able to upload the Neuro report? That would greatly help to clarify exactly what his diagnosis is and more. FOR uploading, you would press the " REPLY" button. Find the "add attachment" or the "add image" button to upload a PDF file or a jpg. TIP for all other posts, go to the QUICK REPLY typing area at bottom of your Lulu's thread to write a reply. Easy, fast and recommended No need to quote an entire post. Use your own words with maybe 1-2 words of reference if needed to make the sentence clearer. We only want to read your words in your post. QUICK REPLY allows you to scroll up and down to a previous post and then back down to the "Quick Reply" typing area to continue your own post.Recovery Suite Ideas -- For easier access to Lulu, convert crate to a top opening one. Easy DIY idea:🚩 dodgerslist.com/wp-content/uploads/2020/05/crate-top-conversion.pdf -- Ex-pen flexibility for accessing Lulu, maintaining mattress and to adjust recovery suite to exact size needed. Ex-pen is very useful for other purposes after STRICT rest has been completed.
Rolled up blanket is to pad out any extra space. And for a neck dog, the bolster might be something they find as a comfort to rest their head on.
Thank you so much for registering! You can now set up to get auto email alerts when there is a post waiting for you.
EMAIL ALERTS
Your can receive email alerts when someone has posted. Timely interaction/communications is needed when helping your dog.
![]() ![]() Bookmark your dog's thread to receive an email alert when someone has replied.
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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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 15, 2024 9:31:06 GMT -7
The adjustment made to Lulu’s 100mg of gabapentin every 8 hours was done on 10/12/24. She yelped the most [10/14]yesterday and a little bit [10/15] this morning. Neurologist [Dr. Christina Isack, DVM, DACVIM] called in ✙ Amantadine liquid 50mg [10/14] yesterday. She’s taking 2.5ml every 12 hours. She had her second dose this morning. [MED LIST/HISTORY- Moderator's Note. Please do not edit
25lbs 12 y.o.
10/8 high liver enzymes, reason for no anti-inflammatory Rx
10/8 local DVM: high liver enzymes, reason for no anti-inflammatory Rx
10/10 wobbly walk; knuckles and corrects front paws
Neuro appt 10/10 with Pred Rx
Prednisone as of 10/10: 5mg 2x/day for 7 days; Sun 10/20 TEST TAPER for: _ pain and _neuro
gabapentin ▲100 mgs ▲3x/day as of 10/12
methocarbamol 250mgs 3x/day
✙Amantadine formula 50mgs/?mL: ?mgs (2.5mL dose) 2x/day
traZODone 50mgs ?x/day
Lulu needs GI tract protector, Pepcid AC, on board for duration of prednisone! ] She did stand up in her Suite 2-3 times [10/14]yesterday despite her yelps. She sits up most of the day and goes back and forth between knuckling and correcting her paws but do see she corrects her paws when she stands. Her pain appears most when she tries to lay down or with movement. I’ve tried a small pillow, towel, etc. I can see she twitches so hoping this amantadine will help. She is getting her meds round the clock as it’s hard to stick with a schedule say 7am 3pm 11pm etc. Example, she got her Amantadine at 7:25pm last night, however she was sleeping very comfortable this morning that she didn’t get that until 9:15am. I’m not sure if giving the needed meds at one time is more effective. It’s not that easy and rest is important. They did not suggest giving Lulu any Pepcid AC at this time. She is eating, urinating and defecating. Was told water will keep her hydrated and keep her from being constipated. All of lulus liver enzymes were high when her blood was done at the primary vet on 10/8; she was not put on anti- inflammatories as a result. I will upload the report. Thank you for your help and concern! Upstate Veterinary Specialities, NY exam 10/10/2024 Neuro Exam: POSTURAL REACTIONS: Absent left thoracic limb paw placement and markedly delayed hopping, moderately reduced paw placement and hopping on the right thoracic limb, seemingly intact in the pelvic limbs.SPINAL REFLEXES: Intact withdrawals x4, intact patellar reflexes, panniculus and perineal reflexes. MUSCULATURE: Obvious cervical pain with muscle fasciculations at rest. Did not perform cervical range of motion Screw tail. No joint/bone pain noted, and no pair thoracolumbar spinal palpation. Abnormalties: Grade Il/VI left systolic murmur, Anatomic diagnosis: Cervical myelopathy with significant neck pain vs. right forebrain Differential Diagnosis: Intervertebral disc herniation (IVDH)  |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Oct 15, 2024 11:14:55 GMT -7
Lisa thank you for the neuro exam report. That clears up quite a bit.
Keep updating your vet about any signs of pain still not fully under control. You are still reporting signs of pain. When the meds are correct, pain is under control in 1 hrs and stay that way right up to next doses of meds.
There are other meds that could be added to bring about full night and day control of pain. Your vet depends on your observations to know if there still needs more adjusting of pain meds while Prednisone is at work to resolve the painful swelling.
Make sure you are PROMPTLY dosing each med on time whether that be 2x/day for some or 3x/day for other meds. You would want to wake her up for her meds so that the level of pain meds stay at optimum level in her body.
What is the formula for Amantidine liquid? Look at the bottle for # of mgs/ amt mL.
The top Differential Diagnosis is for IVDD. Until there is a higher suspicion that she has another disease, Lulu is being treated for IVDD.
Let us know what the Neuro says and any changes if you are still seeing pain Tues 10/15.
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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 15, 2024 14:45:54 GMT -7
Amantadine is 50 mg/5ml.
Lulu did pretty well today. She appears more of her self and actually stood up to eat her dinner.
I will continue to keep the Vet updated on her level of pain. Thank you!
[MED LIST/HISTORY- Moderator's Note. Please do not edit
25lbs 12 y.o.
10/8 high liver enzymes, reason for no anti-inflammatory Rx
10/10 wobbly walk; knuckles and corrects front paws
Prednisone as of 10/10: 5mg 2x/day for 7 days; Sun 10/20 TEST TAPER for: _ pain and _neuro
gabapentin 100 mgs 3x/day as of 10/12
methocarbamol 250mgs 3x/day
Amantadine formula 50mgs/5mL: 25mgs (2.5mL) 2x/day
traZODone 50mgs ?x/day
Lulu needs GI tract protector, Pepcid AC, on board for duration of prednisone!]
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Post by Romy & Frankie on Oct 15, 2024 15:06:10 GMT -7
I am happy to hear that Lulu is standing to eat. Is she showing any signs of pain currently?
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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 15, 2024 15:51:34 GMT -7
We brought her out and she urinated only.
She’s back in her crate but is very uncomfortable and yelping.
She just got her gabapentin and methocarbamol at 6:30pm [10/15]
She’s not due for her prednisone and amantadine until 9:15pm.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Oct 16, 2024 8:28:19 GMT -7
What did the vet add/change yesterday 10/15 to get that pain under control?
It does not seem probably to think that pred might have gotten all painful swelling resolved with the scheduled pred taper to go into effect on Sunday 10/20. Discuss with vet extended days on the original anti-inflammatory pred dose 5mg every 12 hours.
The pred taper is the time to see if pred had done its job. All vets must guess on the number-day pred course. The pred 7-day course is a common guess. However, in many cases, it may take several courses adding up to a range of 7 to 30 days to fully resolve the root cause of the pain.... painfully inflammed tissue around the spinal cord.
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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 18, 2024 7:59:35 GMT -7
Lulu was definitely making a little progress over the last 1-1/2 - 2 days but she did not have a good night last night (her last pred dose was 10/17 @ 9:00 am. [10/17] Last night she would try to lay down but then would get up. It took her at least 2 hours to attempt to lay down.
I spoke with the doctor [Dr. Christina Isack, DVM, DACVIM. Neuro] [10/18] this morning and we are keeping her on the ▲Prednisone 10mg 1/2 tablet every 12 hours as it seems like she’s not ready to taper off at this time.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
25lbs 12 y.o.
10/8 high liver enzymes, reason for no anti-inflammatory Rx
10/10 wobbly walk; knuckles and corrects front paws
Prednisone as of 10/10: 5mg 2x/day for 7 days; Sun 10/20 TEST TAPER for: 10/17 pain and _ neuro
as of 10/18 5mgs 2x/day for ? days, then test TAPER for _ pain _ neuro
gabapentin 100 mgs 3x/day as of 10/12
methocarbamol 250mgs 3x/day
CHANGED:Amantadine formula 50mgs/5mL: 25mgs (2.5mL) 2x/day
Amantadine 100mg pill: 25mgs: 2x/day
traZODone 50mgs ?x/day
Lulu needs GI tract protector, Pepcid AC, on board for duration of prednisone!]
Doctor [Dr. Christina Isack, DVM, DACVIM. Neuro] said this is the best combination of medicine she uses to treat IVDD. However, If it’s a neurological issue such as spinal cord cancer, it can be the reason for continued pain. She is very much on board to treating her conservatively.
We are changing her Amantadine to a pill form as Lulu does not like the taste of the liquid. She also said her therapy department uses an Assisi loop and we can also look into that for her. Our follow up appointment with the veterinarian is on 10/29/24.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Oct 18, 2024 9:09:58 GMT -7
Lisa, great to hear you are on top of any sign of pain or neuro on the pred taper. Good job in getting help quickly.
Would you provide the details to help us understand?
The doctor you spoke with 10/18 is the Neuro, Dr. Christina Isack, DVM, DACVIM?
Amantadine changed to pill.
-- A whole pill is ?mgs ___
-- What is the dose in mgs ___
-- how many times a day dosed? __
What did you observe that indicated she did not have a good night on 10/17. Please describe what you saw re: pain and/or neuro diminishment.
Prednisone
For how many days course is the 5mg 2x/day to be given?
With the change in meds, let us know if Lulu has pain fully under control dose to dose.
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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 18, 2024 10:48:29 GMT -7
Yes, spoke directly to [neuro] Dr. Christina Scanlon Isack [10/18 ] today.
Lulu experiences much pain when she goes to lay down in her suite! She was reluctant to stand up for us to carry her outside [10/18] today and she yelped when my husband lifted her up; but did ok when squatting to pee and defecate. She was able to get up ok we gave her a minute or 2 for some sunshine. She yelped when my husband corrected her paw and also when he picked her up (one hand under her belly other between her front paws). We use a strap for support if she starts to go down into a knuckling front paw position but she hadn’t done that over the last 2-3 days.
When we got her back to her Suite she yelped to lay down but did stay down to rest.
[10/17] Last night she would try to lay down but then would get up. It took her at least 2 hours to attempt to lay down.
I will report back on medications once I pick them up. Thanks
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Post by Romy & Frankie on Oct 18, 2024 13:21:56 GMT -7
I am sorry that Lulu is again experiencing pain. Please let us know about the meds as soon as you are able.
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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 19, 2024 9:44:18 GMT -7
Amantadine 100mg - giving 1/4 tablet by mouth every 12 hours
Prednisone 10mg 1/2 tablet every 12 hours [for ? days] as directed. Dr. Scanlon refilled RX for 30 tablets
[MED LIST/HISTORY- Moderator's Note. Please do not edit
25lbs 12 y.o.
10/8 high liver enzymes, reason for no anti-inflammatory Rx
10/10 wobbly walk; knuckles and corrects front paws
Prednisone as of 10/10: 5mg 2x/day for 7 days; Sun 10/20 TEST TAPER for: √10/17 pain , _ neuro
as of 10/23- 30 (10mg refill tabs): 5mgs 2x/day for 30 days, 11/22 TEST TAPER for: _ pain _ neuro
gabapentin 100 mgs 3x/day as of 10/12
methocarbamol 250mgs 3x/day
Amantadine 100mg pill: 25mgs: 2x/day
traZODone 50mgs ?x/day
✙pumpkin 2 tsp 1x/day
Lulu needs GI tract protector, Pepcid AC, on board for duration of prednisone!]
Lulu had a better night on 10/18. "Better" meaning no pain for 2 days. She was able to lay down comfortably without yelping.
She is eating well still continuing to add water to her food for hydration and giving her ✙pumpkin puree 2 teaspoons 1x a day. She is urinating and defecating.
I also joined the IVDD group on Facebook. Someone mentioned her frenchie was prescribed 200mg of gabapentin 3x a day. Interested to know if milligrams can be increased for Lulu who is 25lbs if needed. Reading that cervical IVDD is extremely painful for dogs and some members also got their dog fentanyl patch. Thank you!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Oct 19, 2024 10:31:49 GMT -7
Lisa, what does "better" mean? Please describe your specific observations that support her pain level change since pain meds were adjusted by the Neuro on 10/18. "Better" is not good enough! Pain needs to be fully in control round the clock, when she has to move, nearing the next dose of pain meds, whether during the day or thru the night. PREDNISONE The very important part of prednisone are the number of days of use prior to the taper reduction in mgs and/or times per day dosing.
Can you upload a jpg of the bottles to help provide this important information? 1) For how many days was the original 10/10 pred Rx of 5mgs 2x/day to be given?2) With the neuro's 10/18 refill, for how many days of pred 5mgs 2x/day are to be given?Be wary of trying to compare your dog's disc episode with another dog's. Only your vet knows your dog's health history to prescribe the dose of pain meds.The time to phone your neuro for an update is when you see that what has been prescribed is not fully controlling pain. With a new Rx, expect pain to be in control within the hour IF, the meds were correctly adjusted.Do not have any patience with pain not fully in control. Call your vet to get pain meds adjusted. Be able to communicate with details of what you see that make you believe she is in pain. "Worse" "better" are not details.PUMPKINWhy was pumpkin puree added?
Was it for loose stool, if so Pepcid AC (famotidine) is what suppresses acids caused by prednisone and the GI upset caused.
GI UPSET This is nothing to fool around with. GI upset can lead to bleeding ulcers. As long as the vet would say Lulu has no health issue to prevent use of Pepcid AC, then go to the grocery store and buy it. Lulu does not need bleeding ulcers on top of all that she is dealing with. Know you stomach protection during the use of any anti-inflammatory including the steroid prednisone: dodgerslist.com/stomach-protection/ |
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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 20, 2024 9:56:33 GMT -7
"Better" meaning no pain for 2 days as of 10/18. She was able to lay down comfortably without yelping. After taking her out this [Sun 10/20]morning, we placed her back in her crate. When she went to lay down today she yelped. She had been comfortable with no pain between doses. Prednisone 10mg - # of tabs 12 - directions give 1/2 tablet once every 12 hours with food for 1 week, then 1/2 tab once daily for 1 week, then every other day until gone. The medications are noted in the neurologist report with the taper dates. I’ve given Lulu pumpkin puree on her dry food before. She does not have loose stool. The neurologist said not to give Lulu Pepcid at this time. She is not vomiting, no diarrhea. What about constipation? Lulu has been averaging 1x a day to poop. [green bottle: prednisone RX'd on 10/10/24. 5mgs 2x/day for 7 days. Taper to start 10/20]  [Brown bottle: Prednsone date not listed. Number of days to give not listed.
Quanty of 10mgs tablets not listed. Not able to determine the new taper date. ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Oct 20, 2024 13:57:56 GMT -7
Lisa, it could be that Lulu is not moving around much and now her new normal is one poop a day. Is the poop well formed or constipated? If you have concerns, do discuss with the vet.
Monitor for that yelp. Could be she expected there to be pain and anticipated it with a yelp? If there are other signs of pain and more yelps, then notify the neuro to see about further adjusting the pain medications while pred is in the process to fully resolve the painful inflammation.
Lisa could you tell us how many whole 10 mgs tablets are in the Refill bottle the Neuro gave you?
Thank you, your pictures are good. However, there is not enough information on the bottle to determine when the next taper date will be tried.
[green bottle: prednisone RX'd on 10/10/24. 5mgs 2x/day for 7 days. Taper to start Sun 10/20]
[Brown bottle:
• Prednsone RX date not listed.
• Number of days to give not listed.
• Quantity of 10mgs tablets not listed.
Not able to determine the new taper date. ]
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Lisa & Lulu
New Member
FEMALE - Boston Terrier
Posts: 9
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Post by Lisa & Lulu on Oct 21, 2024 11:31:56 GMT -7
Hi, Lulu is up to 2 poops a day as of [10/21] yesterday normal in color and consistently formed.
Thankfully she hasn’t yelped again and she is really quite back to herself and no pain.
She lays on her side, is eating well and I tell her easy as I don’t want her in any pain again. When she is outside during potty breaks she is able to sniff the ground and I do keep her on a short leash so not many steps. She is able to stand very well and her limbs look pretty strong.
There are 30 whole prednisone 10mg pills in the brown refill bottle.
The date on the brown refill bottle is 10/18/24;
however, there are 3 half pills of prednisone left in the first prescription (green bottle) dated 10/10. Lulu has one more Pred dose tonight and then the 2 halves tomorrow.
So the start date on the new refill bottle will be 10/23.
There is no taper date noted on refill bottle and since Lulu was still in pain with the first taper attempt, Dr.Scanlon suggested she stay on 1/2 tablet of Pred every 12-hours.
Dr. is on vacation this week but said I can contact her team and she would email or call me if I needed her. My follow up appointment is 10/29/24. Thanks always for your support!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Oct 21, 2024 12:24:34 GMT -7
Lisa, thank you for all the details of especially using dates and counting the pred pills, etc. I'm so very happy to hear pooping is back to normal!! And that the adjusted meds have brought full control of pain night and day. Just as it should be... Lulu can heal in comfort from pain while prednisone works on the root cause. All vets must make a prudent guess as to how long it might take pred to complete its job. All meds have side adverse side effects. Be up to speed on pred side effects: 🚩 vcahospitals.com/know-your-pet/steroid-treatment-long-term-effects-in-dogs A 30-day course on top of a 7-days course of pred does not align. Waiting to find out in 30 more days what pred has done is unusual with what 1000+'s of reports on how vet's prescribe prednisone. Often the prudent guesses for how long a pred course to give are: -- 7-day course -- 14-day course You are ultimately in charge of Lulu. Dr. Dr. Nancy Kay, DVM, ACVIM has hit it on the nail especially with IVDD. Each of us needs to be self educated so we can team up to work with our vets. Being the team captain and playing a very instrumental component of at home care for Lulu, means your understanding of the treatment is essential. When something seems off, that is the time to ask questions on behalf of Lulu to understand the thinking behind prescriptions. You now are aware that something is off. You cannot speak up if you don't have all the facts. There may be a simple answer about why what appears to be a 30-day pred course, but may was not supposed to be a 30-day course. You are like a nurse at a hospital. Your job is to monitor meds. If you see a concern, the doctor needs to be informed so things can be worked out for the patient's benefit. Let us know what you find out about the #-day pred course. The receptionist/vet tech may be able to access the Neuro's notes to provide explanation until you can discuss with your Neuro.
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