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Vaccination cautions with recent disc episode, steroids
Neuro Corner Answers
Dr. Jared Galle
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, spinal trauma, wobbler syndrome, inflammatory brain disease, and developmental brain abnormalities (hydrocephalus and Chiari malformation).
Question
CHRIS ASKS:
When is it safe to give vaccinations to a dog with a recently herniated a disc?
ANSWER
While there are no set guidelines for when to vaccinate a dog after surgery, we recommend to wait for at least 4 weeks after surgery before vaccinating. Some dogs become stressful and anxious when taken to the veterinarian, causing them to “squirm” which could injure the surgery area. Waiting to vaccinate 4 weeks after surgery allows the surgery area to heal.
One should also take in to consideration whether or not your pet has been taking steroids (prednisone, dexamethasone). Steroids decrease the immune system, which may reduce the response to the vaccine. There is no consensus in pets or people as to how long a dog should be off steroids before being vaccinated. Several factors have to be taken into account when considering this (dose of steroids, frequency of the steroids, type of vaccine, amount of protective immunity). Generally, the dose of steroids used to treat disk disease is low enough to not interfere with vaccination. However, we recommend that the steroids be stopped for 2-4 weeks before vaccination.
One should also consider checking a titer to see if vaccination is necessary.
Dr. Jared Galle, DVM
Diplomate ACVIM (Neurology)
Timing pain medications
Neuro Corner Answers
Dr. Jared Galle
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, spinal trauma, wobbler syndrome, inflammatory brain disease, and developmental brain abnormalities (hydrocephalus and Chiari malformation).
Question
BARBARA WONDERS:
If gabapentin given at the same time as tramadol and robaxin would pain relief increase as opposed to giving the gabapentin a few hours after the tramadol and robaxin? I am giving my dog tramadol and robaxin 2 times daily as well as gabapentin 2 times daily. I have been giving the tramadol and robaxin together and then giving the gabapentin about 5-6 hours later as to try to keep some kind of pain medication in his system working toward pain relief. What is your opinion on this?
ANSWER
Hello Barbara and thanks for the question. First, if you feel that your pet’s pain is not being adequately controlled, contact your veterinarian. The medication doses or dosing frequency may need to be changed.
Research studies have found that when when given together gabapentin and tramadol can enhance the effect of each other; therefore, giving the two drugs together may have an advantage for treating inflammatory pain.
You need to keep in mind that not all dogs respond the same way to pain medications. I have had some patients that respond better when staggering pain medications. You should consult you veterinarian if you want to change the tramadol and gabapentin dosing instructions that are on the prescription.
Dr. Jared Galle, DVM
Diplomate ACVIM (Neurology)
Non-steroidals (NSAIDS) vs. Steroids
Neuro Corner Answers
Dr. Jared Galle
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center
Primary interests include intervertebral disc disease, spinal trauma, wobbler syndrome, inflammatory brain disease, and developmental brain abnormalities (hydrocephalus and Chiari malformation).
Question
JODY: Good day doctors,
I have a 12 year old female dachshund. Last week, she was diagnosed by a veterinary neurologist as having IVDD, following an MRI and a lumbar puncture as well. The lumbar area shows one disc that is of concern. His first line of treatment is Metacam for 3 weeks and then return for an appointment. I took her to this veterinarian subsequent to a very quick and almost un-noticeable episode of her dragging her left back leg for about one second. Having had a number of dachshunds I wanted to have her assessed before a crisis arose.
My question is this, looking now at the literature I am seeing that corticosteroids are being used rather than NSAIDs, so I am a bit puzzled at his choice. I would like to read your thoughts before I make an call to him to ask him to help me understand his decision to use the NSAID rather than another medicine. Thank you very much.
ANSWER
Hi Jody, this question certainly opens a can of worms concerning the medical treatment of IVDD in dogs.
I should begin by saying that there is no study to support using corticosteroid (steroids) or NSAIDs for treating IVDD in dogs. Older recommendations to give high-dose, injectable steroids immediately after spinal trauma (ex. IVDD) were based on large human studies. The current recommendation in people is to not give high-dose, injectable steroids with spinal trauma. Based on this, most veterinary neurologists do not give injectable steroids.
On the veterinary side, you will find three medical treatments for IVDD:
- 1. Oral steroids
- 2. NSAIDS
- 3. No medications
The recommendation to treat IVDD in dogs with steroids or NSAIDs is often a personal preference since there is no study to support either drug. Both medications are used to treat pain caused by inflammation. Some neurologists will recommend NSAIDS because there are fewer side-effects when compared to steroids. You should ask the neurologist why he/she recommended NSAIDS over steroids. He/she may have a good reason.
The most important component when treating IVDD medically is to keep your pet crated.
Dr. Jared Galle, DVM
Diplomate ACVIM (Neurology)
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