My Sophie Fell

[Rhetts_mama]

Originally Posted by gidget529

Does the second vet you took her to know she is on Mobic? Anti-inflammatories cause increased risk of stroke. If stroke is suspected, anti-inflammatories should not be used unless bleed versus clot has been ruled out (at least that is what we do in human med). I would call the 2nd vet and make sure he/she wants the Mobic continued w the possible neurologic finding of the one-sided tongue licking.

If I understand correctly, the possibility that it was anything other than a fall that caused the initial symptoms wasn't even suggested until the second visit, so the Mobic would be a reasonable thing to prescribe with the ER visit.

Good thinking about differentiating between hemorrhagic vs embolitic stroke, though wouldn't you expect to see more progressive symptoms with a hemorrhagic stroke (just thinking out loud here... as the hemorrhage continues, further areas are compromised causing increased symptoms...)

Originally Posted by YorkiesRGrrreat

Wow! I am glad I posted on here. I called my vet and he said for her not to take the Mobic. He said it has to be metabolized (?sp) and he doesn't want her to take it. He was not happy that they had given her such a large dose in the ER, but in any event, he wants her to be off of it. He is going to recheck her back just to make sure everything is ok with her. My husband says he always remembers her licking from the left. Weird how I didn't pay any attention to something like that though. I am not going to take any chances though and if he wants to send her to a neuro vet, we will definately go. I don't know why I failed to mention that the ER had put her on this med to my regular vet, but the ER vet told me it was safe ("like Tylenol for us" is what she said) I guess that is why I didn't think anything about it. URGH!!!

Things get forgotten all the time between the ER visit and the follow up. Don't beat yourself up about it. If you ever have reason to make another ER visit in the future, just bring your discharge papers to your normal vet or ask them to fax over the records to your vet for you- one less thing to have to try and remember (works for people ER/Urgent care visits, too!)

Regarding the dosing of the Mobic: Lillymae can probably confirm or deny this for vet meds, but with people we often give a higher dose of anti-inflammatories initially, then cut back to the normal dose.

[gidget529]

[QUOTE=Rhetts_mama;3732260]If I understand correctly, the possibility that it was anything other than a fall that caused the initial symptoms wasn't even suggested until the second visit, so the Mobic would be a reasonable thing to prescribe with the ER visit.

Good thinking about differentiating between hemorrhagic vs embolitic stroke, though wouldn't you expect to see more progressive symptoms with a hemorrhagic stroke (just thinking out loud here... as the hemorrhage continues, further areas are compromised causing increased symptoms...)

Actually, I agree w her regular vet - Mobic should not have been given. When a pt comes into the ER w possible stroke, the first thing worked up is whether it is hemorrhagic or embolic. It dictates treatment given.

In suspected postconcussive states, analgesics given are usually Tylenol containings meds - not NSAIDS. It could precipitate a bleed that is not already present.

[YorkiesRGrrreat]

Thank you so much for all the info and sharing your wonderful knowledge. You guys are awesome! She is doing wonderful. She is running around here like nothing ever happened. I am not letting her out of my sight and watching for anything abnormal.

[Rhetts_mama]

[quote=gidget529;3732279]

Originally Posted by Rhetts_mama

If I understand correctly, the possibility that it was anything other than a fall that caused the initial symptoms wasn't even suggested until the second visit, so the Mobic would be a reasonable thing to prescribe with the ER visit.

Good thinking about differentiating between hemorrhagic vs embolitic stroke, though wouldn't you expect to see more progressive symptoms with a hemorrhagic stroke (just thinking out loud here... as the hemorrhage continues, further areas are compromised causing increased symptoms...)

Actually, I agree w her regular vet - Mobic should not have been given. When a pt comes into the ER w possible stroke, the first thing worked up is whether it is hemorrhagic or embolic. It dictates treatment given.

In suspected postconcussive states, analgesics given are usually Tylenol containings meds - not NSAIDS. It could precipitate a bleed that is not already present.

Not disagreeing with the second vet, once a stroke was considered a possibility a different course of treatment is required while it's being worked up. That wasn't the case with the ER vet, though.

NSAID's vs other med: I suppose it's going to depend on the patient population and regional practices. I've encountered 2 cases in the past few months (1 adult, 1 pediatric) where ibuprofen was the recommendation. I'm not privy to all of the info on the adult case (it was a friend of mine), but the pediatric case was my daughter after she got hit in the head with a bat during a softball game. It surprised me, but the ER doc said it would provide better pain relief (an active bleed had already been ruled out).

In a veterinary situation, your choices are going to be more limited. You can't use acetaminophen in a dog. Stronger pain medications can mimic changes in LOC.That pretty much limits it to NSAID's for dogs. If an active hemorrhagic is of concern, a quick ultrasound could be utilized to rule that out in the office. I wish Ellie May would post on what she sees used most often.

Always interesting to see the differences in practices. That's why going to a vet that knows your dog is so much more effective than depending on advice from strangers on the internet.

I hope Sophie is continuing to do well.

[gidget529]

I'm really not here to debate. I save that for our monthly Mensa meetings.

I'm glad she called the vet and d/c'd the Mobic. I would not be comfortable w giving a child w a HI ibuprofen but to each his own.

I really would discourage the practicing of medicine over the internet. Posters do not know the background of the ppl responding, education or IQs - not to mention possible inaccuracies in histories and no PE possible. I simply asked if her current vet was aware of the Mobic. I see questionable advice at times. I tend to voice my opinion and move on. If someone choses to not take the advice, sobeit.

[quote=Rhetts_mama;3733946]

Originally Posted by gidget529

Not disagreeing with the second vet, once a stroke was considered a possibility a different course of treatment is required while it's being worked up. That wasn't the case with the ER vet, though.

NSAID's vs other med: I suppose it's going to depend on the patient population and regional practices. I've encountered 2 cases in the past few months (1 adult, 1 pediatric) where ibuprofen was the recommendation. I'm not privy to all of the info on the adult case (it was a friend of mine), but the pediatric case was my daughter after she got hit in the head with a bat during a softball game. It surprised me, but the ER doc said it would provide better pain relief (an active bleed had already been ruled out).

In a veterinary situation, your choices are going to be more limited. You can't use acetaminophen in a dog. Stronger pain medications can mimic changes in LOC.That pretty much limits it to NSAID's for dogs. If an active hemorrhagic is of concern, a quick ultrasound could be utilized to rule that out in the office. I wish Ellie May would post on what she sees used most often.

Always interesting to see the differences in practices. That's why going to a vet that knows your dog is so much more effective than depending on advice from strangers on the internet.

I hope Sophie is continuing to do well.

[Rhetts_mama]

Originally Posted by gidget529

I'm really not here to debate. I save that for our monthly Mensa meetings.

I'm glad she called the vet and d/c'd the Mobic. I would not be comfortable w giving a child w a HI ibuprofen but to each his own.

I really would discourage the practicing of medicine over the internet. Posters do not know the background of the ppl responding, education or IQs - not to mention possible inaccuracies in histories and no PE possible. I simply asked if her current vet was aware of the Mobic. I see questionable advice at times. I tend to voice my opinion and move on. If someone choses to not take the advice, sobeit.

I didn't realize we were debating.

[kak877]

My yorkie had a similar situation once. My husband was using the dust buster under the kitchen table. I don't know about yours, but mine hate any type of vacuum. My Chriket went after it and turned to attack it and hit herself off of the leg of a chair. She was knocked out cold. Not moving at all and her tongue was hanging out. I called the vet, we got in the car and were on the way there, when she came to. No broken bones either, but they told me she just had the wind knocked out of her. I have never been so scared in my life. I thought for sure I was going to lose her. These yorkies are the love of our lives, but they are so fragile.