Inflammation around the spinal cord
Pain ReliefPAIN control happens in approximately an hour when a prescription has been customized for your dog’s needs by the dose in mgs, the frequency dosed and a 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 painHolding 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.
Pain medicationsWhile the anti-inflammatory drug works on inflammation in 7-30 days, pain meds must be on board to provide comfort from pain. A two or three-way combination of pain meds is often necessary to address each source of pain during a disc episode . These meds do not stay at a useful level after 8 hrs. Most often it will require Rx’d for pain medication to be dosed every 8 hours. Expect when the correct Rx for your dog is given, then pain would be in control within an hour or less and stay that way round the clock, right up to the next dosing time.
- 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.
Anti-inflammatory drugsThese types of drugs will take anywhere from seven to thirty days to rid the body of all painful swelling. There are two classes that your vet will choose from. The two classes (non-steroids/NSAID and steroids) should not be mixed or used close in time. A 4-7 day washout is prudent to protect from severe GI tract damage when switching from NSAID to NSAID or NSAID to a steroid. Steroids Prednisone, Dexamethasone, etc. NSAIDs Rimadyl, Metacam, Deramaxx, etc.
How long to use an anti-inflammatoryA vet must guess how long of anti-inflammatory course to prescribe. Many vets will try a 7-day or a 14-day course. The end of the course is actually a “test stop.” Along with stoping the anti-inflammatory, all of the meds that mask pain are also stopped. The test stop is the time the owner will be monitoring for any hint of pain resurfacing. Pain indicates more anti-inflammatory time is needed. Also all pain meds and Pepcid AC need to be back on board. Your vet will again take a guess on how long the course should be. After multiple attempts to go off any anti-inflammatory, if pain cannot be totally resolved, surgery should be a consideration.
Acid SuppressionPepcid AC (Famotidine) Is used proactively with ALL anti-inflammatories to avoid serious gastrointestinal damage. For some dogs Pepcid AC needs to be accompanied with yet another protector, Sucralfate, if any hint of signs GI sign appear: not eating,diarrhea, vomit, bloody stools.
Tools to use with medications
There are no safe meds. Just meds which are used in a safe manner by the vet and owners who are knowledgeble about each med their dog takes. The Mar Vista Veterinary web page has an excellent drug look up directory: http://www.marvistavet.com/pharmacy-center.pml
.Dodgerslist Med card
Handy to keep a reference card in your wallet. Useful for keeping all the meds straight as you discuss things with your vet. D/l a printable PDF at this link: Med-card-to-print
.Dodgerslist Med Chart
Don’t miss a dose especially if more than one person cares for your dog. A place to document things. Handy when you discuss things with your vet.
Download PDF which includes a sample and a blank chart to print out: med-chart-printable
.Roadmap to Conservative treatment for the Refrigerator
Avoid dangerous detours. Tape the roadmap on the fridge for handy reference.
VIEW, DOWNLOAD and print from here: https://dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf
Preview of the Roadmap
Acupuncture • Laser Light Therapy
These two therapies can help stimulate nerves to self repair.
CAUTION: 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 with escape of disc material into the spinal cord . Pain again and the need to start from square one. For an animal with very mild neuro deficits, the risk of transporting to therapy has to be carefully weighed against what benefit would be gained.