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     Pain control

What to expect during pain healing

1. PAIN control happens in approximately an hour when a prescription is customized to your dog for the dose, the frequency and combination of pain meds.  There is no one-size-fits-all pain relief.

Make sure the medications are fully controlling pain from dose to dose with no break-through in pain. Continued feedback to your vet is vitally important until the pain medications have been properly adjusted for your dog.

Signs of pain are holding the head in an unusual position...head held high or nose to the ground, shivering/trembling, panting, not wanting to move much or moving gingerly, yelping, tight/tense stomach muscles, holding leg up flamingo style...not wanting to bear weight on the leg, just not their usual perky-interested-in-life self.

A 2-3 combo of pain meds is often necessary to address each source of pain during a disc episode and usually Rx'd for every 8 hours:

  • Tramadol as the general pain reliever. It has a short half life of 1.7 hours and often needs to be prescribed at a minimum of every 8 hours.
  • Methocarbamol treats muscle spasms stemming from aggravated muscles due to nerve trauma related to the spinal cord inflammation.
  • Gabapentin may be added to the mix for hard to control pain. Veterinarians are finding this medication works very well in combination with Tramadol.
  • Amantadine for severe pain. Neuros are finding this drug adds an extra dimension of pain control.

Prescription of an anti-inflammatory such as a steroid (Prednisone, Dexamethasone, etc.) or a NSAID (Rimadyl, Metacam, Deramaxx, etc.)  should be accompanied by a stomach protector such as Pepcid AC (Famotidine) to avoid serious gastrointestinal damage. For some dogs Pepcid AC needs to be accompanied with yet another protector, Sucralfate, when there are signs of GI problems of diarrhea, vomit, bloody stools.

Handy reference card to carry with you
  print link for card:
An anti-inflammatory (* NSAID or * steroid) can take 7-30 day to resolve all pain. When a vet guesses all painful inflammation is gone, a test stop of the pain masking pain meds and the NSAID is called for. Steroids can't be stopped, they must be tapered. During the test taper and stopping of pain meds is the time to watch for any signs that pain is returning, an indication that more time on the steroid is needed. After repeated attempts to go off any anti-inflammatory, if pain cannot be totally resolved, surgery should be a consideration.

* Steroid and NSAID class of anti-inflammatories should not be used together. They require a 4-7 day washout from the body before switching between these two classes of anti-inflammatories.

Acupuncture/laser light therapy help reduce pain and stimulate the nerves to repair. Studies show pain actually slows the healing process not to mention enduring the pain from a disc episode is torturous. 

During conservative treatment, anytime out of the recovery suite is a dangerous time for the early healing disc. Movement of the back/neck can increase a disc tear and escape of disc material into the spinal cord . For an animal with very mild neuro deficits, the risk of transporting to therapy has to be carefully weighed against what benefit is to be gained.

This information is presented for educational purposes and as a resource for the IVDD dog community. The coordinators are not veterinarians or health care professionals. Nothing herein should be interpreted as medical advice and all should contact their pet care professionals for advice. The coordinators are not responsible for the substance and content contained herein and do not advocate any particular product, item or position contained herein.

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