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: http://www.dodgerslist.com/literature/MedCard.pdf
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.
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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.
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