What can I use with Prednisone?

[Duckman]

I am sorry I have been awol this week, but I have had my hands full since Sunday. We had a devastating wind storm on Sunday and we have been inundated with babies since. Many have been in bad shape and I had 3 sisters who came in, after being blown 75' out of their nest, onto the asphalt. I lost 2 Sunday night, as their head injuries were just too much. This remaining little girl though, is a fighter and is holding her own. Unfortunately, Dr. Kelly has been hired by the Portland Zoo, so I am dealing with a new vet. She is just out of school and seems to know everything, so she refused giving this one Prednisone for her fractured skull (she stated that Prednisone will suppress the healing process of the body. She doesn't have any other injuries, so I don't know what healing process she is worried about, since the swelling is the most urgent!). As a result, I have someone sending some to me and I will get it today. The question I have though, is what medications can I give as well (you would think after all this time on TSB, I would know this!)? I know she can't have Metacam with Prednisone and I believe IB is also a no no, being an NSAID. I will post pictures, but she definitely has a depression in her skull, so I know there has to be brain swelling (an Xray by the vet confirmed the fracture).

[SammysMom]

Oh those poor babies...
Godspeed little ones...:Love_Icon:Love_Icon:Love_Icon

Tramadol is the only thing that can be used with Prednisone as far as I know.

[Nancy in New York]

Oh those poor babies...
Godspeed little ones...:Love_Icon:Love_Icon:Love_Icon

Tramadol is the only thing that can be used with Prednisone as far as I know.
I agree, that's the only thing I know of as well SammysMom.

[Duckman]

Perfect! Tramadol it is!! Thanks so much! Pred just got here, so am going to mix and give her first dose. I will get some Tramadol tonight, from Jackie.

[SammysMom]

No Prednisone within 24 hours of NSAIDS.

[Duckman]

She hasn't had anything since yesterday morning. I knew the Pred was coming and didn't want to risk anything. :serene

[Duckman]

No luck on the Tramadol. Jackie suggested Buprinex, but I am not sure. It doesn't show as an NSAID, but it isn't Tramadol. Any ideas? I won't give it until tomorrow anyway, so I have time. :thumbsup

[SammysMom]

I am on my stupid nook so not easy to navigate. Did you google the combo? Is is the blood thinning properties that make the danger.

[LaurelLynn]

Strictly speaking about medication info, buprenex can be used with prednisone as it's an opioid narcotic not an NSAID

I only know drug specifics because I'm a CPhT, not the uses specific to squirrel

[Duckman]

Thank you both! I will use the Bupenex first thing in the morning! She just had her first dose of Pred, so my fingers are crossed it works. She is an angel who needs to stay on this earth for a while.....

[czarina]

Lots and lots of prayers coming for your little one.:Love_Icon:grouphug:Love_Icon:grouphug:Love_Ic on:grouphug:Love_Icon

[Nancy in New York]

Thank you both! I will use the Bupenex first thing in the morning! She just had her first dose of Pred, so my fingers are crossed it works. She is an angel who needs to stay on this earth for a while.....

I KNOW Jackie knows what she is doing,
I just worry about giving such a potent narcotic to a little 70 gram squirrel.
Could you get just ONE Tramadol?

[SammysMom]

According to my vet, because of the help with swelling, the pred itself also acts as a pain reliever. I have always questioned this, but maybe sort of play it by ear and see how she is acting this morning. I have you and your baby in my thoughts and prayers. She is a lucky girl to be in such loving care...:grouphug:Love_Icon:grouphug

[LaurelLynn]

According to my vet, because of the help with swelling, the pred itself also acts as a pain reliever. I have always questioned this, but maybe sort of play it by ear and see how she is acting this morning. I have you and your baby in my thoughts and prayers. She is a lucky girl to be in such loving care...:grouphug:Love_Icon:grouphug

It's interesting the difference in what's considered proper pain relief in human medicine and veterinary medicine. .. I saw this working as both a pharmacy technician and as a vet assistant

In the human pharmaceutical field, prednisone isn't considered a pain relief giving medication UNLESS the ONLY reason for the pain is the inflammation it's treating... it doesn't act on pain sensors

Yet in animal medicine it seems pain is sometimes under addressed.

Sammysmom is correct that any opioid pain relief has a narrow window of dosing to avoid central nervous system suppression BUT dosed correctly it's an excellent pain medication with no drug to drug interactions with prednisone

[LaurelLynn]

Oops I meant Nancy is right about it being potent. ... sorry!

[Duckman]

First, thank you for the recommendations. I have decided to hold off on the Buprenex, mostly due to Fern herself. She is moving her front paws, for the first time since I got her. She is reactive and so much more active, in only 12 hours after the Prednisone. I don't see the same signs of pain that I was seeing previously, especially the open mouth and excessive drooling. Until last night, I had not seen her close her mouth but now she is sleeping peacefully. There is no doubt she has brain damage, but I am hoping that the Pred will help and she can carry on at least a half way normal life. :grouphug

[Annabelle's papa]

:) That's great Duckman, I know you feel better now that the LIL' One is resting better.:Love_Icon

[Nancy in New York]

First, thank you for the recommendations. I have decided to hold off on the Buprenex, mostly due to Fern herself. She is moving her front paws, for the first time since I got her. She is reactive and so much more active, in only 12 hours after the Prednisone. I don't see the same signs of pain that I was seeing previously, especially the open mouth and excessive drooling. Until last night, I had not seen her close her mouth but now she is sleeping peacefully. There is no doubt she has brain damage, but I am hoping that the Pred will help and she can carry on at least a half way normal life. :grouphug

This is a fantastic update! Thank you for posting and keeping us up to date with your little Fern. :Love_Icon

[SammysMom]

Thank goodness, DM! I am so happy to hear that she is responding already. To be honest, this is exactly why I have been so keen on using it. Both of the boys I gave prednisone to because of head trauma reacted to the drug almost immediately. Both had been having seizures and the pred stopped them completely.
I am just so glad that baby got a chance to be in your hands...:Love_Icon:Love_Icon:Love_Icon

[Kristi S]

I am sorry I have been awol this week, but I have had my hands full since Sunday. We had a devastating wind storm on Sunday and we have been inundated with babies since. Many have been in bad shape and I had 3 sisters who came in, after being blown 75' out of their nest, onto the asphalt. I lost 2 Sunday night, as their head injuries were just too much. This remaining little girl though, is a fighter and is holding her own. Unfortunately, Dr. Kelly has been hired by the Portland Zoo, so I am dealing with a new vet. She is just out of school and seems to know everything, so she refused giving this one Prednisone for her fractured skull (she stated that Prednisone will suppress the healing process of the body. She doesn't have any other injuries, so I don't know what healing process she is worried about, since the swelling is the most urgent!). As a result, I have someone sending some to me and I will get it today. The question I have though, is what medications can I give as well (you would think after all this time on TSB, I would know this!)? I know she can't have Metacam with Prednisone and I believe IB is also a no no, being an NSAID. I will post pictures, but she definitely has a depression in her skull, so I know there has to be brain swelling (an Xray by the vet confirmed the fracture).

I'm glad to hear she's doing well. Sheesh, 75' onto asphalt! Amazing she's still holding her own, and that she doesn't have other injuries!

I'm curious - is the injury to the back of the skull? I was wondering why she was drooling. Did she have jaw trauma? What other symptoms does she have?

Brain injury doesn't always mean there's swelling. Why do you think that her head injury is not one of the things that needs healing? Did the vet have some other treatment in mind besides pred?

I was thinking just yesterday that squirrel nests seem awfully vulnerable to all kinds of threats. I read last week that every year half the population of grays dies. Pretty amazing.

[czarina]

I am so pleased that Fern is doing better.Sleep is the best healer of all. I am so happy she is able to rest peacefully.

As time goes on, I can share with you some of the therapies that I use on Loofy, my head injury girl.

I am just so happy to hear of this improvement, I just want to jump!:bliss

Will be eagerly awaiting further updates.:serene

[Kristi S]

In the human pharmaceutical field, prednisone isn't considered a pain relief giving medication UNLESS the ONLY reason for the pain is the inflammation it's treating... it doesn't act on pain sensors




If the inflammation is affecting the brain alone, pred used as an anti-inflammatory won't combat pain since the brain has no pain receptors.

Pred can change behavior in an animal without actually doing anything to heal him or her.

The treatments for brain swelling may be as simple as holding the animal with the head above the rest of the body. There is more evidence supporting giving salt solution to treat brain swelling than there is to support the efficacy of prednisone. I understand how tempting it is to believe that pred is a wonder drug, really I do! But without comparing pred vs. no pred to treat a given problem, with all other factors held the same, there's just no way of knowing how effective it is. In humans with brain trauma it is not effective. This is very well supported by the scientific data. In fact, the largest study done was discontinued after if became obvious that pred increased mortality in victims of brain trauma. It has too many actions that can worsen brain inflammation and its effects, such as elevated blood pressure and seizures, and many more. This is true in rats as well as humans. The list of longer-term side effects is immense, and pred is such a strong drug that it doesn't take a long administration at high doses for the risks to be an important consideration.

There is even evidence that mild brain swelling might be protective in the case of injury.

I know what I say isn't welcome to a lot of you, and it probably seems I'm harping on it. That's only because I keep reading over an over in the scientific literature the same things revealed by different studies, and it's an issue I've come to feel strongly about for the sake of the squirrels and their long-term health.

There are instances where pred is the drug of choice. Some forms of brain disease fall under this category (which is why it definitely is beneficial for some neuro squirrels), but not brain injury.

I suggest you give yourselves more credit for the survival of these beautiful animals that have suffered so much! Your attentive care is so important, and so admirable! Proper rehydration, administration of pain killers to alleviate stress, keeping the squirrel from getting too warm (that includes its body, since blood is constantly circulating to the head), protecting it from further injury...these things you do all help the body and brain to recover.

I am so moved by the love I see here every day, and the support, help, advice and friendship you provide each other is truly inspiring. I wish I had more squirrel stories of my own to contribute, and soon I shall (volunteering at a rehab center caring for orphaned squirrels), but for now all I have is knowledge - or opinion, depending on how you choose to take it. It's up to you. All I ask is that you keep in mind I only want to help. :hug

[Duckman]

It is with great sadness and a heavy heart that I must report that my little Fern gave up her battle last night, in her sleep. She had been doing so well, even at her last feeding. I think she had something very compromised internally, that finally let go. Godspeed my little Angel! :sad

[SammysMom]

Godspeed sweet Fern.... :Love_Icon:Love_Icon:Love_Icon

I am so sorry Michael...you gave her the very best chance anyone could have given and she took much love along with her to the Bridge. :grouphug:Love_Icon:grouphug

[Annabelle's papa]

Godspeed sweet Fern.... :Love_Icon:Love_Icon:Love_Icon

I am so sorry Michael...you gave her the very best chance anyone could have given and she took much love along with her to the Bridge. :grouphug:Love_Icon:grouphug

:Love_Icon So very Sorry DM, as SammysMom said no one else could have given Her a better chance.:sadness

[LaurelLynn]

I'm so sorry to hear about your loss :grouphug

Although i know you wanted to give her the gift of a full recovery, what you gave her instead is equally wonderful and generous ... you gave her a warm, comfortable place when she needed one; she passed with a full belly and with someone to grieve her loss who will remember her. That's so much better than had she spent her last day hungry, wet and cold in this Washington rain. I'm sure she is thankful for you

[Nancy in New York]

Though you have had your share of heartache, it gives me
peace knowing these special little ones are with you when they
breathe their last breath.
Thank you for making her final journey home filled with love, comfort,
respect and tears.
We should all be so lucky.
Rest in Peace
Little Fern 253933

[Kristi S]

I'm so sorry. You and she put up a fight, but as you said, sometimes there are hidden injuries that overcome the body's ability to heal. She was fortunate to have your love and care until the end.

[island rehabber]

I am so sorry to hear this, Duckman. Run free again, little Fern :sad

[Shewhosweptforest]

:grouphug:Love_Icon Fern & Duckman :Love_Icon:grouphug