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Inflammation, swelling in the spinal cord 

What to expect during the inflammation/swelling phase of a disc episode

 SWELLING of the spinal cord may take anywhere from 1-2 weeks with post-op swelling.

With conservative treatment reduction of swelling can take 7-30 days on a NSAID or a steroid (but never both together) to resolve the pain caused by inflammation. Swelling is best resolved by using the big-gun medications rather than herbs. Glucocorticoid steroids are synthetic versions of the body’s naturally occurring hormone, cortisol.  Steroids are basically the most powerful of anti-inflammatories. With IVDD, an anti-inflammatory dose is used rather than a higher immuno-suppressive dose used for other diseases. There are no safe medications. There are two safety factors with drugs. One is a vet who practices safe medicine with a blood test to verify the liver and kidneys are healthy prior to starting the medications. The other is an owner who is well read and educated on what the side effects are and monitors their dog.

With mild symptoms of pain and no neurological deficits, some vets will choose a NSAID. NSAIDs also are potent drugs calling for owners to be self-educated about the side effects and a vet who checks the health of the kidneys and liver via blood tests before prescribing.

When using either a steroid or NSAID, an acid reducer such as Pepcid AC is necessary. Dodgerslist follows those vets who are proactive in protecting the stomach, choosing not to wait until a bleeding ulcer or life-threatening stomach perforation happens. NOTE: FDA and manufacturer package inserts warn against use of a NSAID with a steroid or with another NSAID without a washout period of 4 to 7 days before starting the new medication. Vets that practice safe medicine require a 4- to 7-day washout period between the medications.

The tapering off of a steroid is a health necessity to signal the body to make its own steroid hormone. The steroid taper also allows a peek into the status of swelling. If pain returns, your vet needs to know and likely more time on the steroid would be prescribed. No signs of pain means the steroid has done the job. NSAIDs do not require tapering off and can just be stopped when the vet believes  all the painful swelling might be gone.  NSAIDs require the same observations of pain returning and contacting the vet promptly to extend use. There really is no way to know how long it can take to resolve swelling.

Rule of thumb:
pain = swelling = more time on anti-inflammatory, pain meds and Pepcid AC needed.

The "why" behind the above rule: Often it takes being at the anti-inflammatory dose level anywhere from 7-30 days. When the vet guesses swelling might be gone there will be a test. If NSAIDs, that drug will be stopped along with pain meds to give a clear picture whether all spinal cord swelling has actually been resolved.

If steroids, there must be a taper for health reasons.  Usually the first course of a steroid at the anti-inflammatory level will be 5 or 7 days and then a taper. To have a clear picture on a steroid taper, pain meds are also stopped or backed off too. The steroid dose is lowered to less than the anti-inflammatory dose.  The owner's job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain.  Immediate feedback to the vet about any pain is necessary.  Often a "plan B" with your vet is decided on so that if the pain happens at night, weekends or holidays when the vet is not open, the owner knows what action to take, what meds to give til the vet can be contacted again. A "plan B" can save an expensive ER trip.

Adverse side effects to monitor when using any anti-inflammatory 

NSAIDs
Aspirin, ETOGESIC (etodolac), RIMADYL (carprofen), METACAM (meloxicam), DERAMAXX (deracoxib), LOXICOM (meloxicam) PREVICOX (firocoxib), ZUBRIN (tepoxalin), NOVOX (carprofen), Ketoprofen, GALLIPRANT (grapriprant)


Any one sign is enough to STOP giving the drug to your dog and call your veterinarian immediately!
  • Not eating or eating less
  • Lethargy, depression, changes in behavior
  • Vomiting
  • Diarrhea, red or black tarry-colored stool
  • Yellowing of gums, skin, or the whites of the eyes
  • Change in drinking
  • Changes in skin (scabs, redness, or scratching)
FDA information
Steroids
Prednisone, Prednisolone, AZIUM or VOREN (Dexamethasone),  SOLU-MEDROL (methylprednisolone), Cortisol, VETALOG (Triamcinolone Acetonide), SOLU-DELTA (Prednisolone Sodium Succinate)

These are serious signs of GI tract problems which can quickly move to a life threatening situation, get with your vet ASAP about a 2nd stomach protector, Sucralfate, in addition to Pepcid AC (famotidine)
  • Not eating
  • Vomiting
  • Loose stools, diarrhea
  • Red or black blood in stools

Temporary side effects of steroids:

  • Panting- fan near the recovery suite but not pointed at dog can help.
  • Drinking more and eating more
  • Bladder filling up every 2-4 hours and the need to provide frequent potty breaks or expressing sessions

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Disclaimer:
This information is presented for educational purposes and as a resource for the Dachshund 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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