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Post by agneslulu on Oct 5, 2013 12:57:44 GMT -7
Hi all,
I'm Jennifer, mom to Mackenzie, a 33-lbs 11-ish y/o beagle/basset mix. On Wednesday (10/2) I rushed her to the vet. She was in pain, yelping when she moved a certain way and refused to put pressure on her right front leg or raise her head. She could wag her tail and walk, but was wobbly. After a physical exam and x-rays, the vet told me she had a calcified disk in her cervical vertebra (around C5 or C6, I believe). They gave her some meds and sent us home with a paper on IVDD, more meds, and instructions for crate rest for 3 weeks. Since then, she's been on strict crate rest, only out to potty and eat in the room with her crate (her bowl - designed to make her eat slower - is too big to fit in the crate with her). The meds the vet prescribed were:
-prednisone 10mg every 12 hrs
-tramadol 50mg every 12 hrs
-she also take 10mg of enacard daily for Congestive Heart Failure (diagnosed about 1.5 yrs ago)
Wednesday night and most of Thursday she did well - eating and drinking, no problems going potty, poop looked normal, finally able to shake her head, but would cry/yelp occasionally (on Thursday). Friday she was showing signs of pain even more. Last night, I gave her the meds around 6pm and by 1am she was crying and yelping in her crate. Not knowing if giving her more meds that soon would harm her, I waited until 6am this morning (Saturday, 10/5), then had to wait another hour or so for the vet office to open. By then she could not stop yelping and shaking, and wouldn't hold her head up or put pressure on that right leg. She's staying over the weekend (and possibly longer) at the vet's where she could be hooked up to an IV and monitored.
Since I couldn't sleep last night, I went up and down this website and am so glad I did. Now I know she shouldn't be in pain between doses and that there are possibly other meds I can discuss with the vet (including pepcid ac). And to continue crate rest for 8 weeks. I definitely want to thank all of you who have contributed to this site and board, it's been immensely helpful. Any other advice/tips you have are greatly appreciated.
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Post by Christina & Bug on Oct 5, 2013 16:24:04 GMT -7
Hi..my name is Christina..my dog Bug is going through this with his neck as well. Adding the gabapentin to Bug's meds really seemed to help with pain control. Bug walked the same way you are describing, and now he is walking better. He is able to shake his head without yelping, although he is still stiff. It is amazing how getting the meds right makes such a huge dfiference. This site has been amazing for me...so reassuring and has kept me from panic! Best of luck to you...be patient and do not give up!!!
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StevieLuv
Helpful Member 
Conservative Treatment 3x. It really does work!
Posts: 1,335 
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Post by StevieLuv on Oct 5, 2013 17:28:31 GMT -7
Hi Jennifer, my name is Maureen. Welcome to Dodgers List - I am sorry that Mackenzie is having an IVDD epidode. You did a great job geting her back to the Vet for pain control. Neck discs are miserable, and the pain can be difficult to control, often requiring a combo of medications. Here is a link to the information on cervical (neck) discs www.dodgerslist.com/literature/cervical.htmYou are off to great start with all of your reading! By becoming a reader you will ensure that Mackenzie gets the best care possible, because you will be an educated advocate. Please keep us posted, and let us know when she gets to come home. We are in this together and there is a wealth of information available to you on this site. Keeping you in thought and prayer.  |
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Post by agneslulu on Oct 7, 2013 16:13:48 GMT -7
Hi Christina and Maureen. Thank you for the warm wishes and the info. Christina, I hope Bug is doing well.
I just spoke to the vet and will likely be able to pick Mackenzie up tomorrow morning! The vet asked me to bring in her medication because it will likely be changed. I will definitely be asking about the gabapentin and pepcid ac.
One question - is it the prednisone that is to be tapered off? At our first visit, the vet gave me enough (pred and tramadol) for 10 days and scheduled a visit 2 days after the pills would be gone. Reading the material and other posts, I've noticed that others talk of a taper off/cutting back period. Is this something I need to address with the vet?
Thanks for all your help!
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Oct 7, 2013 16:39:07 GMT -7
Prednisone is the one that is tapered off, so that her body will start producing it's own steriod. I hope that she gets to come home on schedule - they are so much happier (as are we) when they are home |
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Post by agneslulu on Oct 9, 2013 7:28:54 GMT -7
Mackenzie was able to come home yesterday! I spoke to the vet about medication. She approved Pepcid AC but wasn't that familiar with gabapentin. I'm to bring Mac back in about a week to see if she can be weaned off of prednisone and the vet will look into gabapentin. In the meantime, I was given more tramadol (still 50mg) up to 4 times a day. I've decided to do tramadol 3 times a day and another if she shows signs of pain. The vet did say Mackenzie might have to be on some kind of medication, like Rimadyl, for life. Last night Mackenzie had me up nearly every 2 hours to potty and for water, but she seems to have settled down now that the stronger meds are out of her system. Our vet office has 4 vets (it's a walk-in clinic) and I must say I do like this vet the most because she has always been aggressive with treating Mac's various illnesses and injuries.
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Post by Jean & Mimi on Oct 9, 2013 7:36:22 GMT -7
Glad things seem to be going better Hugs to your furbaby! |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Oct 9, 2013 11:42:30 GMT -7
Jennifer, I'm sure both of you are happy now that Mackenzie is back home. As long as Tramadol is controlling pain fully, then 3x a day is good. Nice to know you do have 4x a day as back up if needed and your vet is researching gabapentin. Let us know that you are not seeing any signs of pain: holding her head high or nose to the ground, holding her front paw flamingo style..not wanting to bear weight, tight tense tummy, not her normal perky self.
The hope is that Pred WILL get all the swelling down in the spinal cord and that the disc will shrink back enough to no longer irritate the nerves so that no medication will be needed for the rest of her life.
Just so you have an idea of how Pred works…. During the time on the anti-inflammatory the pain med(s) do need to be adjusted so that there is no pain surfacing dose to dose of pain relief medications. Pain will deter the whole healing process.
Often it takes being at the anti-inflammatory dose of prednisone for 1-2 weeks or even for some dogs more like a month before all the swelling is gone. When the vet guesses swelling might be gone there will be a call for a taper. The dose is lowered to less than the anti-flammatory dose and eventually ends with an every other day dose and then stopped. Your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain and tell the vet of your observation during a taper. To have a clear picture on a taper, pain meds are also stopped or backed off too.
Rule of thumb is:
pain = swelling = more time on Pred needed.
If there is no pain on the taper then it goes to completion. Then no meds at all are needed. Disc healing will continue for the remainder of the 8 weeks. Nerve damage (such as wobbly walking) can continue to self heal…think in terms of months.
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Post by agneslulu on Oct 9, 2013 15:45:44 GMT -7
Thank you, newbiemomiv1! And thank you for the information, Paula. That was really helpful. I think tomorrow and the next day will be reckoning days to see whether the tramadol 3x a day is working. It was the second day home from the first vet visit where she started showing pain. |
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Post by agneslulu on Oct 17, 2013 21:28:43 GMT -7
Went to the vet Tuesday to▼ taper off Prednisone. I was instructed to give half a dose twice a day and to also reduce the tramadol. She didn't give clear directions on the tramadol so I reduced that dose by half as well. Wednesday I started the half doses (5mg prednisone 2x day, 25mg tramadol 3x day). Unfortunately, when I got home from school tonight she was back to yelping and crying in pain. I gave her a full dose of both meds and will ring the vet in the morning. I think the trip to the vet aggravated her condition (getting her into the crate in the car was a trial). Plus, I came home on lunch break on Wednesday to find my grandma (whom I live with) walking Mac (trying to see if she would poop) despite strict instructions not to. I know she means well, but it's a frustrating situation. Mac is still eating and using the bathroom normally and her tail is typically set to wag so I know this setback is temporary. Doesn't stop the fear or worry.
How often is too often to give tramadol? I gave Mac a pill (50mg) about an hour ago ( 10pm) but Mac is laying in het crate whimpering in pain.
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Post by Jean & Mimi on Oct 18, 2013 5:26:22 GMT -7
I am so sorry. I had to start back on the meds after two tapers. Going to try a third taper next week. (((HUGS))) and hope Mac got some relief.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Oct 18, 2013 8:37:14 GMT -7
I'm sorry that Mackenzie's first taper wasn't pain free, Jennifer. It just means, as Paula explained, that the swelling in the back hasn't gone down yet and Mackenzie needs more time on the steroid. However, the fact that Mackenzie is still in pain an hour after giving her 50 mg of Tramadol indicates that she needs more than Tramadol to control her pain. Please discuss again with the vet adding Gabapentin to the mix. Tramadol can be given every 6 hours.
It's very hard when someone in the household doesn't understand the importance of crate rest. Maybe explaining to your grandmother that the crate is acting as a cast to heal Mackenzie's back will help her to understand. Do you know how far she walked Mackenzie? It's hard to know if it was the extra movement that may have caused the disc to re-tear or whether it was the taper of the steroid that has caused the pain. Did Mackenzie show any sign of discomfort after the walk or was it only after the taper that the pain started? Please tell your vet about this incident of walking when you speak to them so they're aware of that as well.
Also, I see that when your grandmother was walking Mackenzie to try to see if she would poop. Is she having difficulties pooping? The meds can cause constipation. Pumpkin can help firm up stools OR it can help to loosen stools. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. To firm up the stool, add 1 teaspoon pumpkin to kibble and no extra water 1x a day. Note alternatives for constipation: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potato.
Please keep us posted as to what the vet says after speaking to them. Prayers that Mackenzie's pain will soon be under control again.
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Post by agneslulu on Oct 19, 2013 14:47:51 GMT -7
Thank you for the kind words, newbiemom. I hope the 3rd taper is the charm!
Marjorie, it's hard to tell what might have contributed to the pain because the walk happened on the same day as I started the taper. All I know is that they were walking around the yard, but I don't know for how long. Mackenzie hasn't had a problem pooping (she goes 2x/day), my gran was trying to be helpful since I'm in and out of the house every day because of work and school. I've told my grandmother not to take her out anymore; I'll just have to come home on lunch and in-between classes.
I visited the vet yesterday (Friday) after work, but she was in surgery and we had to relay info to each other via a vet tech. That did not go well. I explained the situation about the walk and tapering attempt on Wednesday and her being in pain the next day and how I went back to the original doses (btw, Mac showed no signs of pain yesterday and this morning). The vet wants me to continue the taper over the weekend and, if she showed signs of pain, to bring her in Monday. I was not happy, but after a couple of more information passes through the vet tech, I left since I was getting nowhere.
Honestly, I have enough Prednisone to continue full doses for a week and then do a 10 day taper (the length of time the vet prescribed for this first step in tapering), but I'm hesitant to do that. I did give her half a dose this morning, but I'm scared to cut back on her Tramadol (which I know is necessary). I really don't know what to do. Today I've left messages with a couple of other vets in my area, but haven't heard anything back yet.
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Post by Pauliana on Oct 19, 2013 20:22:46 GMT -7
Hi Jennifer, I would go back to the full dose of the Prednisone, since she is in pain and also every 6-8 hours on the Tramadol. She may need Methocarbamol for muscle spasms in her neck or Gabapentin for nerve pain and hard to control pain, but be sure to discuss that with her Vet since she has congestive heart failure in case it is contraindicated. Neck discs are so much harder to get pain under control because the head and neck move with every move she makes and the pain meds need to be aggressive to get her comfortable. Try again to talk with the Vet since she was in surgery the last time. I know how hard it is to talk through other people and get what you want to say across. That sounded very frustrating for you, I sympathize. Here is a link that explains what to look for in an IVDD Vet: www.dodgerslist.com/literature/VetchkList.htm |
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Oct 19, 2013 20:51:44 GMT -7
I'm with you and Pauliana on this one- go back to your original dosages and speak with your Vet directly. You are right, it is too soon to taper, she was already showing signs of pain, so waiting til Monday isn't a great idea.Hope she feels better soon, and that your Vet is more helpful in the future.
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Post by agneslulu on Oct 29, 2013 11:03:40 GMT -7
Just a quick update - other than that one incident of pain, Mackenzie has been successful so far in her weaning off Prednisone. I've been doing 1/2 a dose of Pred twice daily for a little over a week. Today, we start 1/2 a dose once daily for a week and then the vet says to stop Pred after that. Does that sound right? I've read different accounts of how to taper off Pred, so I don't know if that's too fast. I've also tapered off the Tramadol; she hasn't had any for 2 days and is not in pain. She's back to doing full body shakes, stretching, and digging a den in her bedding. (While that's great to see - I wish she would stop.  Makes me so nervous.) We are almost halfway thru with crate rest and I know Kenzie can't wait to go back to the dog park (although that won't happen until late Jan/early Feb). Thanks to all here for your support and info. |
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Oct 29, 2013 11:44:43 GMT -7
She's doing very well with the taper so far, Jennifer. Just keep a close eye out for signs of pain and immediately report any signs of pain to your vet. It's excellent that she is not in pain and feeling so well. I know how nerve wracking they can be when they start feeling better! But these are all great signs that the swelling has gone down in her back and hopefully the taper will continue to go well.
Continued prayers. Please keep us posted.
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Makes me so nervous.) 