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Showing results for tags 'hard decisions'.
I know that many of you have been here.. I don't know exactly why I'm posting. just.. Since Aston was diagnosed with lumbosacral stenosis back in April, I've tried to research and talk to different vets in order to eliminate any possible pain resulting from the condition, now and going forward. Prednisone was off the table for months, since I was getting differing opinions on whether a) it would help, and/or b ) it would result in disastrous side-effects that would outweigh the good. After trying various NSAIDs with limited (but at least some apparent) positive effect, I took him to a third, greyhound-savvy vet to get another opinion on the situation. Thus far, I had one vet telling me that pred would not only NOT help, but would also destroy Aston's cartilage in addition to muscle wasting, and another vet telling me that pred was the next step, and we should just try it and see what side effects might come up, and deal with them (and/or stop the pred). Over the past several months -- since April/May -- we've also had Aston on a few other meds: the Robaxin/methocarbamol (muscle relaxant) has had the most profound effect, helping to unclench the muscles immediately around his lumbosacral joint; we added gabapentin and tramadol for a shotgun effect, more or less, since it is hard to tell whether Aston even has a good, pain-free baseline due to the recurrent corn in a toe pad on his left-hind foot. The corn has been an issue as long as we've had him, and based on pre-adoption medical records from his last home, he's been limping since he got off the track at 2 years old. I've been hulling it and booting that foot (therapaw), with no evidence that it's helping his limp. The new vet took one look at Aston and said that before addressing the stenosis, we would need to address his obviously very-painful corn, and proceeded to numb Aston's toe and dig the corn completely out. The corn left a gaping hole in his toepad wherein his flexor tendon was visible -- this was packed with antibiotic gel and his foot was bandaged. The vet and I then proceeded to discuss the use of oral prednisone or a local depo-medrol injection to treat Aston's LS symptoms. The vet decided to start Aston on pred with a loading dose, then tapering down to a lower, every-other-day dose to see how he dealt with steroids overall before committing to a ~6-week injection of depo. The corn was hulled two weeks ago. Aston has been a full-on tripod for 95% of that time -- I thought that he had basically been used to three-legging it with the corn intact, but he is very worn out. We had to let Aston's Rimadyl wash out of his system before going to pred, so the first week of healing involved no anti-inflammatories as well.. it was noticeably hard on buddy, so I checked with the vet and increased his Tramadol for that week. I removed the original foot bandage after three days (smelled strongly corn-chippy, but not infected), and was relieved to see no swelling or suspicious ooze -- but clear ooze from the deepest part of the hole, nonetheless. I have been packing the hole with neosporin, padding the toe with gauze and re-wrapping the foot every other day since. Last night, I removed his bandage to find that the hole had filled in, no ooze (or tenderness) when I squeezed the toe pad, so I washed his foot and left it uncovered. In the meantime, we started loading pred a week ago. Heavy panting, drinking, peeing, drinking, peeing. Aston appears to have lost weight, but I wonder how much of that was just inflammation, thus far (his muscles are much more visible, suddenly). He is looking to be on the lower side of his 'normal' weight, so we are feeding him extra grain-free cookies and an extra (small) meal before bedtime. He had an especially rough time the night before last, as we had strong wind gusts, which usually cause Aston to pace anyway. He spent most of the night pacing and panting, and it was hard to differentiate what was a need to pee and what was anxiety, so I was coaxing the poor guy in and out of the windy backyard all night (no dog door). Thankfully, yesterday was our first day of tapering the pred down, and he was much calmer last night / quicker to settle after pee breaks, except for the wee morning hours -- lots of panting, again, had a hard time settling. He had finally settled at 5:30 this morning, and when he didn't bark at me for breakfast at 6am, I decided to let him sleep in a bit, since he'd had a rough night. At 7am, I called him off of his bed for breakfast to discover that his healed(?) foot was HUGE, and Aston couldn't bear weight on it at all. He refused breakfast, which he has NEVER done. Off to the e-vet. E-vet determined that we were in the very early stage of an abscess in the corn-pad. Lancing revealed blood only (and lots of it). X-ray clear, but it did reveal a bone spur and definite arthritis in the neighboring lateral, often-weight-bearing toes. Aston was given an antibiotic injection with oral abx to start tonight, along with a soak solution for his leg (2x daily). Going back for a recheck on Tuesday. The vet ran a full blood panel, since Aston is due (he started the bulk of his meds a little under 6 months ago); his liver values are elevated, likely due to the pred. Denamarin 1x daily for 12 days, then re-checking his values at that time. Aston is now panting occasionally, but has settled for a few dreamless naps since we got home. He has a bit of his appetite back for cookies and stinky things, so we got his morning meds into him little by little (making sure to get him to eat enough, with pepcid, to protect his stomach from the prednisone). A cookie lured him up to go pee outside a few minutes ago, so at least he's not panting because he has to go potty. I am thankful that going to the vet's office doesn't provoke an inordinate amount of stress for Aston, since he's no stranger to vets at this point. However, I've spent a lot of time today fighting tears over the knowledge that Aston's Todays have been largely painful lately. It's so hard to tell what the pred is doing, whether it's helping, whether his tummy hurts, whether his throat is dry from panting. His movement is much more fluid than it was prior to starting pred, I think, but I have to see around his painful limp to picture what's going on. I hope so hard that his corn toe will heal up and give him some pain-free time before the corn returns. I wish I had pursued getting the corn removed sooner; so many vets shrugged it off and told me to just keep hulling it, to no effect; or, perhaps I wish I had left it "well enough alone," whatever that means for a dog who's been unable to walk comfortably on that foot for at least 8 years. No pain-free baseline for comparison. The ever-patient patient: I wish that his foot and leg hadn't turned into a red, shiny, bloated, painful mess while he's already dealing with the pred in his system. I had forgotten that pred can also slow healing... I have this picture in my head of Aston being in his best-case scenario, LS handled with nerve-pain, muscle-relaxant, analgesic and anti-inflammatory drugs to cover all bases and wipe out his pain; and no pain from that awful back foot. However, Aston doesn't have that picture in his head.. just an ever-wiping tally of Today I'm in pain, Today I got a cookie, Today I'm going for a walk but it hurts and why is Dad turning us around early to go back home? Better a day too soon; but what if it's months too soon? I know his infected foot will heal; that's short-term... I know his corn will likely come back, but hopefully not soon. His spine can't heal, so we're just trying to make Today the best we can. He did regain his pre-LS-diagnosis activity level prior to adding the pred (but a day on a double-dose of Metacam gave me a glimpse into what a stronger anti-inflammatory could do for Aston -- it was incredible -- so I am hoping...)... I worry that I'm so far down the rabbit-hole that I can't see what this is like for Aston. But today, he's on antibiotics, so his foot should feel better soon, right? and that will be one less thing...