any help with my case?

RE: any help with my case?

Anthony Todd — Tue, 27 Aug 2019 16:31:21 GMT

[quote user="Julie Innes"]I think owners generally think injections are somehow more potent than tablets. They are always keen to ask "do you not have a jag you can give him?" Maybe it's down to compliance??[/quote]

[Well they are more potent timewise.....]

For sure! I've had owners of very deceased animals pleading " can't you give it an injection or something"!

But "the injection"does get the owner on side, so you can get your thoughts and ideas across backed up by the obvious dramatic response by the next morning making them much more likely to accept your advice than that of DR Google and his colleagues "next door."...

Of course posters here will affirm that owners are so much smarter and educated now and won't be impressed by this "quick fix" even if the animal obviously does.

The other advantage is that you get a very obvious and definite idea that the Csteroid has, or has not, helped, and in 24hours max, which you never won't usually get with oral pred.

RE: any help with my case?

Julie Innes — Tue, 27 Aug 2019 15:37:43 GMT

[quote user="Anthony Todd"]

All dinovets just judged drugs by the results on patients rather than theoretical projections and, in general, injections of Csteroids seemed, subjectively and by effect, to work better quicker and more obviously, than tablets whatever the dose, particularly in an acute case.

Certainly in the initial stage of treatment.

[/quote]

My only issue with this is that, especially in judging pain relief, we are relying on owners! The same owners who swear that the worming tablet they gave their dog 3 months ago caused its renal failure, or that the half teaspoon of turmeric they gave it yesterday "worked wonders" (ie, nothing to do with the NSAID we added in 2 weeks ago...)

I think owners generally think injections are somehow more potent than tablets. They are always keen to ask "do you not have a jag you can give him?" Maybe it's down to compliance??

RE: any help with my case?

Anthony Todd — Tue, 27 Aug 2019 12:18:10 GMT

[quote user="Edward Jones"]My understanding of corticosteroids is that whilst they vary in potency they all have exactly the same mode of action.[/quote]

Certainly in the initial stage of treatment.

RE: any help with my case?

Anthony Todd — Tue, 27 Aug 2019 11:03:15 GMT

[quote user="Anthony Todd"]All may not be lost???[/quote]

Those still at the coalface may be able to persuade a generic manufacturer to reintroduce PLT

RE: any help with my case?

Edward Jones — Tue, 27 Aug 2019 09:01:33 GMT

[quote user="Anthony Todd"]

If you think the dog is still in pain you may find that a more potent C'steroid like Depomedrone will give better relief as I always found pred., while great for controlling allergies, never worked well with "back pain".

Of course there's also PLT which can be remarkably effective too, if only it was nearer manufacturing price as it used to be!!

[/quote]

My understanding of corticosteroids is that whilst they vary in potency they all have exactly the same mode of action. Therefore the variation in potency is simply compensated by the dose used for the individual drug. i.e. methylpred is more potent than pred. Use more pred for the same effect and for the same level of side effects.

I may well be completely off the mark!

RE: any help with my case?

Aine Seavers — Tue, 27 Aug 2019 03:11:10 GMT

We don't have galliprant here in Oz but certainly looks like a worthwhile adjunct for o/a etc.

RE: any help with my case?

Anthony Todd — Mon, 26 Aug 2019 15:56:12 GMT

[quote user="Bob Russell"]

Unless something has changed PLT has gone for good as I understand it. A great loss IMO!

[/quote]

All may not be lost???

From the supplier...

Unfortunately, there is a long-term manufacturing issue with this product, as such we sadly do not know if/when we can expect further supplies of the PLT tablet.

RE: any help with my case?

Chris Milligan — Sun, 25 Aug 2019 04:33:16 GMT

[quote user="Thomas Johnson"]If you did take this approach but wanted an NSAID you might be better to use Galliprant,[/quote]

totally agree - we've been having great results with galliprant

RE: any help with my case?

Bob Russell — Sat, 24 Aug 2019 10:19:01 GMT

Unless something has changed PLT has gone for good as I understand it. A great loss IMO!

RE: any help with my case?

Anthony Todd — Sat, 24 Aug 2019 10:13:39 GMT

Of course there's also PLT which can be remarkably effective too, if only it was nearer manufacturing price as it used to be!!

RE: any help with my case?

onecarisma — Thu, 22 Aug 2019 13:38:20 GMT

thanks for your help, I d like to specify that the dog was panting prior to tablets were presscribed but after as well..

RE: any help with my case?

Aine Seavers — Thu, 22 Aug 2019 03:55:12 GMT

Total agreement re the Tramadol-it could be all the signs. So capricious in which dog it will work in due to receptor/mediator issues esp if using human original formulation. There is now an Apex dog quick release version which claims to have efficacy-haven't seen the research papers on it-only heard the spin from the company and offer to a lunch training session-which i don't want, I want to see the data in full for myself. Until then tramadol off the list. Panadol and Gabapentin work so well together-and all neuro clases clindamycin deficent so thats a starter. The presence of pain and of temperature was also a good d/d narrower. Have you done any bloods?

RE: any help with my case?

Neil Wheadon — Wed, 21 Aug 2019 22:58:28 GMT

[quote user="onecarisma"]Tramadol and paracetamol- could t control well the pain - panting a lot and very restless.[/quote]

Take of the Tramadol, but do it gradually. (as in people)

I repeatedly see this with Tramadol where they pant and are restless. In my honest opinion it's result of the drug rather than the pain it is failing to help.

Neil

RE: any help with my case?

Julie Innes — Wed, 21 Aug 2019 17:14:54 GMT

Only other thing that I noticed was "possible infectious polymoyopathy"- worth some antibiotics??

RE: any help with my case?

Thomas Johnson — Wed, 21 Aug 2019 08:34:16 GMT

[quote user="Michael Woodhouse"]

GP vet here not an expert, but if this was my case:

Take off the Onsior and Tramadol - keep on paracetamol at full Pardale dose (33mg/kg) three times daily and chuck in gabapentin. Good whack of prednisolone (I'd start 4X25mg) daily. Stick on clindamycin and reassess 1 week.

If dog needs NSAID as well then I would with signed off licence form, but try without.

[/quote]

If you did take this approach but wanted an NSAID you might be better to use Galliprant, it should be less of a risk with the prednisolone.

RE: any help with my case?

Michael Woodhouse — Wed, 21 Aug 2019 00:21:44 GMT

GP vet here not an expert, but if this was my case:

If dog needs NSAID as well then I would with signed off licence form, but try without.

RE: any help with my case?

onecarisma — Tue, 20 Aug 2019 21:20:40 GMT

6 years old mastiff cross , male, (80kg).

acute onset of pain on lower spine and hinds( reluctant to jump in the car), x rays revealed small OA changes on the spine but small distance between femural head and acetabular joint in Right hind.On Onsior, Haha, Tramadol and paracetamol- could t control well the pain - panting a lot and very restless. Ct scan revealed this info... What are your thoughts and should I reffer or just control with pain relief meds?