cervical pain in basset

Re: cervical pain in basset

Andrew Kent — Sun, 05 Sep 2010 11:05:09 GMT

I think these cases become quite difficult to manage without at least a small investment from the client. I would think a blood profile would be a good starting point - particularly if looking slightly pale - coagulopathies will often show initially as neurological signs - I have certainly have a number of IMTP cases present seizuring etc.

If that is all normal then consider plain radiographs and CSF tap - if you are not familiar with doing these there is a good guide in the new BSAVA procedures manual. They are fairly easy to examine in house if you have a microscope and this will reduce the lab costs etc.

Good Luck!

Andy

Re: cervical pain in basset

Rob Smith — Sat, 04 Sep 2010 19:06:08 GMT

[quote user="Hannah Wynne Richards"]

Dex-in spite of the academics I think it's better for discs-prob reduces swelling -at least that's what I think

Depending where you are, might be worth adding 1/2 strength panacur, if responsive continue for 21 days-could have bleeds from angio ( shh about casvade )-also check access to warfarin

Otherwise try to talk them into at least basic haematology and plain rads

Wynne

[/quote]

Oh dear you've been listening Bayer too much. Great marketing strategy - invent a problem, scare people to death, sell your product!

Re: cervical pain in basset

Evelyn Barbour-Hill — Fri, 03 Sep 2010 23:57:42 GMT

Pethidine and tramadol are cheap.

I know we have to "offer a range of options" but really, ...........................

Re: cervical pain in basset

talia — Fri, 03 Sep 2010 22:44:43 GMT

no no vomiting etc as far as i know..wasnt me who saw it first time so not entirely sure why this tx (cerenia etc was chosen) not so pale now. offered xrays etc but said would have to think about finances when quoted price, responded well to buprenorphine inj but wore off within 12hrs (so rimadyl inj not likely to have had much effect) but they wanted to try it on rimadyl tablets. I'm not really convinced they are gonna do much tbh, dont think they are strong enough to control his pain atm. still no conc proprioceptive deficits etc.

Re: cervical pain in basset

Hannah Wynne Richards — Thu, 02 Sep 2010 08:58:43 GMT

Dex-in spite of the academics I think it's better for discs-prob reduces swelling -at least that's what I think

Depending where you are, might be worth adding 1/2 strength panacur, if responsive continue for 21 days-could have bleeds from angio ( shh about casvade )-also check access to warfarin

Otherwise try to talk them into at least basic haematology and plain rads

Wynne

Re: cervical pain in basset

Utlendigur — Wed, 01 Sep 2010 23:26:15 GMT

Just going back to the start..Was it vomiting? You said no GI problems (is it still eating?) but it was on Cerenia (vomiting?), Zantac (melaena or V+ blood?). It had pale membranes - is it anaemic (pcv is cheap to do, if they can't afford full blood count) or poor perfusion -is it still pale? It doesn't seem overly pyrexic (unless I've converted C to F wrongly). I must admit I tend to think of cervical disc lesions with bassetts which can present at just neck pain, and sometimes pain can cause lethargy and pale membranes.

[quote user="talia"]

not insured so not sure what imaging they can afford and surgery etc. but otherwise conservative tx, strict rest and nsaids or steroids?

[/quote]

Could ask them - give them a few options and approx costs, pros and cons - eg gold standard MRI etc, basic Xray +/- bloods, bargain basement conservative + nsaids/prednisolone or other corticosteroid

Re: cervical pain in basset

Evelyn Barbour-Hill — Wed, 01 Sep 2010 22:28:53 GMT

I may be being a bit stupid here (It's not my field! It's not my field! ), but shouldn't you be taking some plain radiographs now before worrying about fancier stuff? Sure, there may be no visible abnormality, but if there is it would be silly to miss it.

And, er, CSF tap is not too difficult if you allow yourself plenty of time.

[quote user="Jessica Fawkes"] so much happier within 12 hours starting steroids.[/quote]

How many steroids? What kind? Oestradiol? Sorry, bit of an obsession.

Re: cervical pain in basset

Jessica Fawkes — Wed, 01 Sep 2010 21:16:59 GMT

without a specific diagnosis (likely to require good imaging (MRI / CT or myelography ) , possibly CSF tap, you are only supplying symptomatic relief. (A position I've found myself in often) . Always seem to respond better to steroids in the end. After "going off" steroids, I started reaching for NSAIDS first, only to have owners contemplating euth as their dogs were continuing to be very miserable. 24-48 hours of bridging tramadol/ fentanyl etc to allow NSAIDS to washout, only to have them so much happier within 12 hours starting steroids. Possibly a reflection of how many cases are steroid responsive meningitis's?