Pain Medications with a disc episode

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Role of pain medications

with a disc episode

“The Buddhists have a saying: Pain is inevitable, suffering is optional. Those of us who work in veterinary medicine have pledged ourselves to recognize, relieve, and prevent pain and suffering in the animals entrusted to our care.”
Robin Downing, DVM, CVA, DAAPM. Pain Management and the Human-Animal Bond. Handbook of Veterinary Pain Management. (Paperback) Elsevier. 3rd ed. 2015. p3.

The anti inflammatory drug (steroid or a non-steroid) rids the body of painful inflammation. Understand, this process may take in the range of 7 days to upwards of 30 days to resolve the painful swelling. While the anti inflammatory is at work,  pain must be absent round the clock. Pain not only hinders healing but makes it impossible to properly care for a dog.  Pain medications work to relieve pain in an hour when correctly prescribed for your dog’s needs.

You are the eyes and ears for your vet at home. You will want to understand how pain medications work and what to monitor for. Never have any patience with getting pain under full control.

Alert your vet immediately when seeing pain is not being managed so pain meds can be adjusted. The Mar Vista Veterinary Drug Directory is an excellent source of information about your dog’s meds.  LINK: http://www.marvistavet.com/pharmacy-center.pml

There is no one-size-fits-all pain relief

Expect PAIN to be in control approximately within the hour, if a prescription is customized for your dog.  The vet may need to tweak and adjust the dose, the frequency given and a 2-3 combination of different pain meds to get full pain control.

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

A 2-3 pain medication combo is often necessary to address each source of pain during a disc episode. In addition those pain meds are very typically prescribed to be dosed every 8 hours to maintain an effective pain control level in your dog’s system.

Signs of pain

❏ shivering-trembling❏ slow to move

❏ arched back, ears pinned back

❏ restless, can’t find a comfortable position

❏ looks up with just eyes and does not move head and neck easily

❏ holds front or back leg flamingo style not wanting to bear weight

❏ yelps when picked up or moved❏ tight tense tummy

❏ head held high or nose to the ground

❏ slow or reluctant to move much in crate such as shift positions

❏ not eating due to painful chewing or in too much overall pain

❏ not their normal perky interested in life selves

med-chart-previewMedication chart 

A medication chart is useful to see patterns, have dates and specific facts handy as you discuss things with the vet.

Download a sample (includes a blank form) to use with your dog’s meds.


“Pain management is a field of medicine that is changing very rapidly. If a veterinarian hasn’t been to any lectures on pain management in the past two years he or she is likely out of date already.
Multimodal therapy is the norm in pain management today. Pain is very complicated, with multiple pathways, neurotransmitters and receptors. No single pain medication works on all of these pathways. The more severe or chronic the pain, the more likely it will require two or more medications given together to control it. We are trying to interrupt pain pathways to the brain in as many places as we can.”
http://www.bestfriendsvet.com/library/orthopedics/rehabilitation/pain-medication-101/

The below list of drugs used to manage pain are the more commonly used. Your vet has many options with other pain meds in his effort to find the right combination to give full comfort from pain for your dog.

  • ▼ NERVE PAIN
▼ NERVE PAIN

Veterinarians are finding this medication works very well in combination with the synthetic opiate tramadol. To maintain an effective level in the body, vets most often prescribe both gabapentin and tramadol for every 8 hours dosing.

“In addition to escalating doses, more frequent administration may be necessary. The pharmacokinetics for dogs and cats indicate that gabapentin administration every 6 to 8 hours, rather than every 12 hours as commonly used, may be needed to provide serum concentrations of gabapentin that are adequate for analgesia. Thus, for each patient, both the dose and the administration frequency may need to be explored, for which we need to engage the client/caregiver.
For adequate control of moderate to severe chronic pain, multimodal analgesia (i.e., use of more than 1 mode of treatment) is almost always necessary….must be used as part of a multimodal protocol with true analgesic drugs like NSAIDs, opioids, and gabapentin.”
Grubb, DVM, PhD, DACVAA, Tamara. Gabapentin and Amantadine for Chronic Pain: Is Your Dose Right? Today’s Veterinary Practice. 2019. http://todaysveterinarypractice.com/gabapentin-and-amantadine-for-chronic-pain-is-your-dose-right/?fbclid=IwAR0KvwH2fgA9iaBvq6uD3gY-9yub0oBtcYiOW6DESKl-6WswOV033vVpO9I

  • ▼ GENERAL ANALGESIC
▼ GENERAL ANALGESIC

Tramadol is a synthetic opiate which is used as a 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.


  • ▼ MUSCLE RELAXER
▼ MUSCLE RELAXER
“In dogs with cervical disc disease this [muscle spasm] may be the most predominant clinical sign. It is therefore useful to employ muscle relaxants in the treatment regime. Diazepam is an excellent muscle relaxant, but in dogs reaches inconsistent and generally poor blood levels after oral administration. More effective is injectable or rectal administration. The former, if given intramuscularly, can cause pain at the injection site. More frequently used are drugs such as methocarbamol (orally or parenterally). The exact mechanism of action of methocarbamol is unknown.”
James M. Fingeroth, DVM, DACVS. January 2006 Surgery.

  • ▼ PAIN MED ENHANCER FOR SEVERE PAIN
▼ PAIN MED ENHANCER FOR SEVERE PAIN
This drug is used for severe pain. Neuros are finding using this add-on drug gives an extra dimension of pain control when added to a 3-way cocktail of pain meds already on board. Because amantadine’s contribution to pain relief is not really analgesia, the drug must be used as part of a multimodal approach in combination the anti inflammatory drug, an opioid such as Tramadol, and gabapentin.

  • ▼ PHANTOM NEUROPATHIC PAIN— paralyzed legs
▼ PHANTOM NEUROPATHIC PAIN— paralyzed legs

Neuropathic pain is abnormal, phantom pain. This explains why a dog with paralyzed legs with no deep pain sensation (DPS) feels this type of pain.

Everyone has experienced numbness or pins and needles tingling in your legs when sitting in a bad position for too long a time.  Your dog can be feeling abnormal nerve sensations that are mild pins and needles to  quite  painful burning, on-fire feeling that makes them bite to stop the pain.

Be watchful for attention of licking or biting of penis, paws, or legs by a paralyzed dog. Stay on top of signs moving to  excessiveness licking, chewing on body parts as this can lead to death.  Immediately put a e-collar on or a lengthwise folded towel and secured closed with duct tape.  Get to a vet for an e-collar and a medication to help to control these very painful sensations.

Directions for an emergency folded towel secured closed with duct tape to prohibit a dog reaching legs + picture:
http://forum.greytalk.com/index.php/topic/220138-create-your-own-surgical-collar/






Disclaimer:

This information is presented for educational purposes and as a resource for the dog IVDD 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.

©2020 Linda Stowe, founder of dodgerslist.com and www.facebook.com/Dodgerslist


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