Urgent: Chicago People Pls Help

[Guest GoingGrey]

Elvis went into ICU at the local ER vet this am and they haven't been able to control his pain for cervical spinal issues all day. I've consulted with Dr. Jenifer Barker, who used to be the racetrack vet in WI and knows what pain cocktail Elvis needs but they won't give it to him due to his current aspirin regimen, etc....

This has happened to other grey owners at this vet where people where minutes away from putting their dog down there before Dr. Barker was able to successfully intervene.

 

I need to transfer him out of that ER to another overnight vet that will accept her pain protocol. I would drive him to Kenosha, WI for her to treat him, but unfortunately she is out of town in Seattle.

 

I need a grey knowledgable overnight ICU vet who can give him the pain IV he needs...anyone??

 

Thank you!

[Batmom]

VCA Aurora, maybe???? Hope you can find a solution

[Batmom]

P.S. Depending on where in Chicago you are, other options besides VCA might be UW Madison or the animal emergency medical center in Rockford (I would call the latter first and talk to the vet on duty before driving out). Hugs and best luck.

[juliemac]

CARE Animal hospital on Palatine rd in Arlington Heights ... http://www.carevets.com/... 847-394-0455

[Newgreymom]

UW Maidson

[4My2Greys]

No advice just prayers and white light..

[NeylasMom]

I wouldn't worry so much about grey knowledgeable, just find a good specialty clinic if you really feel he's not getting the best care where he is. I hope he turns around soon!

[tbhounds]

Sounds like they want to give him a corticosteroid (pred) and won't because I assume he's on daily low dose aspirin? If so, that's ridiculous. Giving aspirin at 40mg or under is perfectly fine to give with pred. I had one of my own girls on that protocol-prescribed by Dr Couto himself. We did concurrently use gastro protectants (Prilosec and carafate) and I never encountered a problem.

I hope you were able to get help for your boy-honestly he shouldnt have been moved last night.

Edited April 22, 2016 by tbhounds

[TwiggysMom]

I'm not sure which hospital you are using, but I would assume CVES as they are the most well known. I prefer Premier at 3927 W. Belmont (formerly called AETC). They also have a hospital up in Greyslake.

 

Twiggy's oncologist is at Premier (but only at the Greyslake location now) - he is very greyhound savvy, as he has had several of his own greyhounds.

 

Twiggy was cared for at Premier on Belmont for her stroke.

 

I'm so sorry to hear things have become so difficult for Elvis - I hope he can turn things around quickly!

[Guest GoingGrey]

He's at MedVet, formerly CVES (Chicago Emergency and Veterinary Specialty) on Clybourn. His pic is featured on their blood donation brochure there... So I guess it's less about greyhound knowledgeable and more about a vet who is not going to fight me on giving him an "unusual" pain relief cocktail, that contraindicates his aspirin regimen and narcos as stated below. Here's what our former track vet, Dr. Jenifer Barker said:

 

"Greyhounds don't do well with the narcotics especially with Fentanyl( it causes hyperthermia as well which can kill then). My protocol for cancer pain is : Meticam Anti-inflammatory, Tramadol( up to 300mg every 8 hours), Gabapentin ( up to 600mg every 8hrs).And if muscles are cramping from pain give 750- 1000 mg of the muscle relaxer Methocarbamol. If you can get the ER to stop the narcotics and give all 4 that I have stated he will get comfortable. a lot of ER,'s do not have a clue how to control pain in our greyhounds. Your consult is not uncommon for me so I hope the vets will listen."

 

The attending who fought me on this yesterday has owned greys, went to OSU and said she was Dr. Couto's daughter's best friend, so I really don't know what I can do or why this is happening.

 

There does seem to be agreement that it's likely an osteo tumor that's pressing on the spine, although nothing showed up on the xray. The newest attending just called for an update: He's still quite uncomfortable this morning tho he at least got sedation overnight (after I went back in a demanded they take off the fentanyl patch and use sedation it 1am.) They are continuing to pressure me to do either do an MRI, which I don't know if I should, or let him go. They also keep telling me that sedation doesn't help his pain. **? I know it doesn't "solve" it long term, but it does give immediate relief, especially to a dog so uncomfortable he won't lie down, right? They keep saying it only knocks him out and while he's knocked out he still feels the pain.

 

I was prepared for an osteo diagnosis (prepare for the worst, expect the best, right?) and to take him home with some pain meds and enjoy, celebrate and spoil him for whatever little time he had left. I wasn't prepared to leave him there for good. Or for all this friction from them.

 

I didn't go to sleep night before last; i was up reading all the osteo threads until I finally took him to the ER when it was clear he needed to go. Dr. Barker said she's seen this exact situation and symptoms many, many times over. And she described his symptoms and his full body muscle cramp, etc. before I even told her. She had another client who got her grey out of this situation minutes before they were to euthanize her, took her a vet that would work with Dr. Barker and then, with the right med cocktail she improved beyond expectation and lived 4 more months. I would take 4 more days--or even hours--if he could just have it without pain. But it may be too late for that. I don't want him to suffer a minute more if I can help it...

[Hubcitypam]

The attending who fought me on this yesterday has owned greys, went to OSU and said she was Dr. Couto's daughter's best friend, so I really don't know what I can do or why this is happening.

Small world. My vet dated Dr. Cuto's daughter.

While fentanyl is an opiate I had two greys do well on the patch....one prescribed by the head of small animal surgery at Texas A&M who owned racing greys. For some reason its cousin morphine is another story in my experience. Rex had the controversial depo medrol injections which really helped his back end for 2-3 years. The surgical referral center said in the end his problem was probably a Smores Nodule (maybe google that).

Sending to you and your boy.

 

Edited April 22, 2016 by Hubcitypam

[TwiggysMom]

I would see about transferring him to Premier. Maybe call them first, and see if they would consult with Dr. Barker and/or follow her pain protocol.

 

Or is it possible that whoever is on duty today at MedVet would be more open to her advice?

 

I'm so sorry you are having to fight to get his meds changed. I hope you can get someone to listen and get Elvis' pain under control.

[tbhounds]

I can tell you that every single greyhound that has a limb amputation perfrormed on a gh at Ohio state receives fentanyl. I understand that many ghs don't do well with most opiates (morphine) but handle fentanyl pretty well. I would put that patch back on or better yet see if they are equipped to give him a CRI drip (constant rate infusion). Don't let him pass without doing an MRI-if this is ivvd then there's a greyt chance that this can be corrected.

[NeylasMom]

I'm so sorry you're going through this. I don't really have sound advice. I do agree with the vet that sedation is not enough if he's in that much pain. Was he having a bad reaction to the Fentanyl? I'm guessing that their concern with the protocol you're suggesting is adding an NSAID (the Metacamm) when he's been on aspirin so recently. Typically you have a washout period between anti-inflammatories. What about a compromise - get him back on the Fentanyl, add in Gabapentin (I would dose as frequently as every 6 hrs) and see what that gets you. In the meantime, they've stopped the aspirin, right? So it might be reasonable to add a different NSAID soon. And I like the idea of the Fentanyl drip rather than a patch as it gives them more options for stopping or adjusting it.

 

If you're not comfortable with the treatment you're getting, that's really tough. I'd say move him, except if he's in that much pain I'm not sure it's a good idea.

[Guest GoingGrey]

@tbhoundsOh he was started on a drip of fentanyl yesterday morning. The patch was additional, I believe. He's been hooked to IVs for more than 24hrs now.

I don't have $3000 for an MRI but maybe I can charge it?

 

I read about ivvd after reading (your?) posts the other day, wondering if this could be a possibility. It's neck pain, so it's cervical spine. Does that apply in ivvd?

 

I'm so brain dead right now and freaking out because how do I know what the right decision is right now?

[Guest GoingGrey]

the aspirin was just the 1/4 baby aspirin he gets daily from me for stroke prevention. There's liability involved, I assume, if they give him some of the nsaids Jenifer prescribed and something goes wrong, despite the fact it's really not enough to matter and he hasn't had any aspirin in over 24 hrs now. She's taking exams this morning, so she's not available.

 

Having such a hard time figuring out which medicines he's on and which he SHOULD be on.

 

i think he got (is getting?) gabapentin, methocarmbamol, diazepam & tramadol.

 

She suspected the fentanyl was agitating him, causing the panting and restlessness. But given all this and he's still in pain this am, i feel he's suffered too long already and I feel horrible about that and i guess it's time...?

[RaineysMom]

if you are thinking about letting him go then the vet should see NO harm in trying what Dr. Barker is suggesting she is the BEST and I would trust her with my pup's life.

 

we had good luck at Arboreteum View in Downers Grove several years ago, but they are now a VCA ER and I've heard good and bad things about that group

[Guest GoingGrey]

is there anything an MRI could see that would be worth the cost/risk at this point?

 

It can't see cancer/tumors that didn't show up on an xray, can it? Again, xray was clean, but I understand it could still be cancer, just not showing in the neck/chest/lungs yet, right?

 

And an MRI can only determine the degree of disc damage if any, correct?

 

Full anesthesia is required for MRI and that in itself could be a risk for a 10 yr old, yes?

[Guest GoingGrey]

Yes, Jenifer is absolutely GOD (or DOG, if you subscribe to my religion) when it comes to greys. I've attended 2 of her grey health seminars and assisted her doing a dental on Elvis and heard stories from her days on the track, fixing up broken leg dogs after a race even when the owner wanted them put down.

 

I'd trust her with my own life. ha. She's educating herself even further at the moment, which is why she's out of town and unavailable this morning.

 

What came thru clearly in all her lectures is how much you have to fight and advocate for greys in regular vet world. Not only due to ignorance but the extreme lack of flexibility or deviance from "normal" protocol because of all the corporate and legal red tape barriers.

 

Do i go put him down now?

I wish to dog I had her guidance right now.

Is the MRI worth it?

if he's hooked to IVs and can't walk without crying every other step, i don't think I should move him to another facility, even tho all this has been twice as costly at this ER/Specialty clinic than it would have been anywhere else, even in the fanciest part of the sucky city. sigh...

[NeylasMom]

the aspirin was just the 1/4 baby aspirin he gets daily from me for stroke prevention. There's liability involved, I assume, if they give him some of the nsaids Jenifer prescribed and something goes wrong, despite the fact it's really not enough to matter and he hasn't had any aspirin in over 24 hrs now. She's taking exams this morning, so she's not available.

 

Having such a hard time figuring out which medicines he's on and which he SHOULD be on.

 

i think he got (is getting?) gabapentin, methocarmbamol, diazepam & tramadol.

 

She suspected the fentanyl was agitating him, causing the panting and restlessness. But given all this and he's still in pain this am, i feel he's suffered too long already and I feel horrible about that and i guess it's time...?

If he is truly on all of those plus Fentanyl I don't see where you really have to go with pain management. An NSAID isn't going to make *that* much of a difference I don't think if we're talking about cancer pain, especially bone cancer.

 

I know absolutely nothing about IVDD though and trust tbhounds input so if that's a real possibility and you can afford the MRI then perhaps it's worth it? The risk of anesthesia is really death so I don't think that's a factor here. There are other possibilities - Neyla had a paradoxical reaction when she came out of anesthesia and got very panicked, but she was a spook and wasn't on sedatives prior to being anesthetized so I really don't think anesthesia is a serious risk when the alternative is already putting him down.

 

Maybe it's time for a heart to heart with the treating vet? Say that you're having a hard time taking all of the information in, ask for her to review the medications he's currently on and why specifically he's not on others that you are interested in, ask what information can be gleaned from an MRI and how that would affect treatment options, ask specifically about IVDD and take notes through the conversation so you can remember what she said. Then take some time to think everything over, or come back here with your notes.

 

Edited April 22, 2016 by NeylasMom

[tbhounds]

Do not put him down! Get him back on the cri fentanyl-get him zonked out on it. Do the MRI-you need an answer-the MRI will show everything-masses, disc, thrombosis .....

It will yield the answer to if this can be fixed or not.

[dmdsmoxie]

Jennifer,

 

Can you post your email address you don't have enough posts to get PM's.

 

Dick

[Guest GoingGrey]

jenwed@me.com

773.726.8045

 

on the phone w/Barbara Karant from G.O. now...

 

not going to do the MRI cuz he's 10 and if he needed surgery, I wouldn't put him thru that anyway

 

the concern is why he's not getting pain relief/or why he's agitated and panting. I know this can happen on fent, but I feel like it could be the IV tramadol, cuz when i started him on that orally at home 1 day before, that was when he went rapidly downhill with the panting and not being able to stay lying down...just needlessly restless all the sudden...does that ring a bell for anyone w/r/t Tramadol?

[tbhounds]

Don't discard surgery-esp because he's only 10yr. If surgery is required it's not always a difficult surgery. I know plenty of dogs that had spinal surgery that had a quick recovery and never looked back.

Whichever you decide to do-and I know it's a very difficult decision for you-we all know you love him dearly and your decision will not be made in haste.

I had a girl with ivvd and I have had ct scans and mri's done on my dogs--please shoot me any questions that may arise.

[Guest GoingGrey]

thank you so SO much--all who've taken the time reply today. Unbelievable news:

 

I was about to head in and see him one last time, and called to confirm with the vet. BUT they are discharging him at 3!

After the disheartening call at 9, he apparently then went to sleep on his own (he's off IV meds--did not know that!), ate food and even limped outside to pee.

 

I'm in shock. Elvis couldn't even walk or lay down (w/o sedation) last night and was nonstop heavy panting! Maybe he heard that Prince had died and didn't think the King should too?

 

Holy rollercoaster batman. I feel like such a drama queen. Will keep you updated...

 

xoxo