Lumbosacral Stenosis, Prognosis, Questions

[Guest sbgreymom]

Hi all - I'm new to the Greytalk board, but have had my beloved hound Beck (Reko Becktemba) for 7 wonderful years.

However, last week what seemed like old age turned into an inability to jump onto the couch (horrors!) and a tendency to fall down when he sneezed.

 

I took him to the vet, along with the printed page of Lumbosacral Stenosis info by Dr. Stack, and sure enough that's the diagnosis.

Unfortunately my vet, who can't be more than a few years out of vet school, seems very reluctant to try the Depo-Medrol shots. He wants to first try NSAIDs (Peroxicam), and if that doesn't work, try oral prednisone. He seems to feel there's a risk of injecting into the spine itself (hitting spinal cord). Has anyone heard this before? Does anyone know what additional resources I can provide him to convince him to try?

 

So far Beck's been on the Peroxicam 3 days with no results whatsoever (surprise surprise), and has already had one awful episode today of shivering pain. This is a dog who's otherwise amazingly healthy - even ran in the Solvang Streak fun run this past February and put a lot of the younger dogs to shame - and to see him laid low is breaking my heart.

 

I guess I'm looking for advice, and also to hear how things turned out for other dogs with this condition. Beck will be 11 years old tomorrow, and my rational mind knows I must just give thanks for each day we have together from now on. But my heart wants to fight for more!

 

Thanks so much...

[Guest Greensleeves]

Whistler was 11 when we finally convinced our vet to try the Depo-Medrol, and we are so thankful we did! He got diminishing results from each successive shot, but we credit the treatment with dramatically improving his final year of life with us. It took some doing (and, hate to say it, having my DH start pushing for it) to talk the vets into it, but after other treatments had no effect, they were willing to try. They've now given the treatment to other dogs at the clinic, too, and shared Dr. Stack's information with other local vets.

 

(I should maybe mention that Whis was on oral pred, also, for another condition, and it didn't seem to affect his LSS at all.)

[Guest crazy4greys]

My bridge boy Phoenix had LS. He had Adequine injections along with Chiropractic adjustments. It helped until the end. He did not pass from LS, but from his kidneys and liver failure. He was also on prednisone and Tramadol(only 1 day due to a bad reaction to it).

 

I highly recomend a chiropractic and acupuncture. My girl Autumn is now getting adjustments and acupuncture every month for the rest of her life.

 

Good Luck!

 

I took him to the vet, along with the printed page of Lumbosacral Stenosis info by Dr. Stack, and sure enough that's the diagnosis.

Unfortunately my vet, who can't be more than a few years out of vet school, seems very reluctant to try the Depo-Medrol shots.

 

My chiropractic vet was willing to do the Adequine injections while Phoenix was there. Maybe you should look for a chiropractic vet to help you with the LS instead of your regular vet. JMO

[Guest sbgreymom]

My chiropractic vet was willing to do the Adequine injections while Phoenix was there. Maybe you should look for a chiropractic vet to help you with the LS instead of your regular vet. JMO

 

That's good advice. I think that's my next step... after all, both chiro and acupuncture have helped me with me own back problems far more than "regular" medicine.

 

And I actually had a Depo-Medrol injection in my knee on Friday - they are a somewhat painful procedure, though worth it in the long run. I'm hopeful that I'll find some complementary treatments to keep injections few and far between for Beck.

 

[Guest sbgreymom]

Whistler was 11 when we finally convinced our vet to try the Depo-Medrol, and we are so thankful we did! He got diminishing results from each successive shot, but we credit the treatment with dramatically improving his final year of life with us.

 

 

I see from another post on the board that your Whistler went to the Bridge last night... I am so sorry.

 

Thank you for sharing this information. I'm going to go back to my vet and try again! I just want him to be happy and comfortable.

[Batmom]

Perhaps there is another vet in your area who has given the shot before and is comfortable doing it? Perhaps yours could even help you look for one and refer you?

 

Hugs and luck!

 

 

P.S. I have had two Reko dogs. Batman (RIP) was slightly related to your handsome boy.

[Cynthia]

It's hard when you have to convince the vet of the efficacy of a treatment, when you're not an expert yourself. So I can understand the dilemma. Did your vet read the information on Dr. Stack's site? She clearly explains that it's almost impossible to hit the spinal cord based on the injection site, and the only downside is that the depo medrol may not work.

 

"This is an easy procedure that you do with the dog standing up, basically an intramuscular injection into the lumbosacral area. There is absolutely no danger of hitting the spinal cord or any important structures. The worst thing that can happen is that it doesn't help the dog. " Dr. Stack

 

 

If you didn't leave a copy of the article with your vet, could you email her the site address and ask her to review it?

 

My Katie (not even 6 yet) seens to be suffering from this. (She flunked the thumb test wildly.) I am fortunate to have an open minded vet who raced for the computer when I told her about Dr. Stack's website. My vet suggested trying the depo medrol because she agreed that it would be very unlikely to cause any harm, and my little girl was in pain. She is still not herself, but is talking to me again (she had gone silent with the pain, a bad sign), and is a bit more active and able to do slightly longer walks again. We may need to see a neurolgist and have an MRI if we don't see more improvement soon. (But also considering chiropracty and acupuncture.) She's at least young enough for surgery.

 

If you can't get anywhere with your vet, how about contacting your group to see if they know of other dogs in the area with the condition who have been treated for this with depo medrol. They may be able to help you find another vet who can help your boy. A second opinion isn't a bad idea!

 

 

 

 

 

 

[ahicks51]

When the depo shots are so straightforward, and the results are so dramatic, perhaps it would be best to have your vet contact Dr. Stack directly? (The only reason I'd hesitate is that they're very busy over there in Yuma.)

 

If not, perhaps you should find another vet that is willing to do the procedure. I'm sure the one you have is very good, but when someone with as much experience with greys as Dr. Stack feels sufficiently confident to post "the fix" on the Internet, she must have very good reasons for doing so.

[Hubcitypam]

Suzanne Stack told me that if it is done correctly there is no chance of hitting the spine. The shot goes into the muscles on either side exactly where the thumbs go for the test, not millimeters from the spinal cord. That probably doesn't help you...unless you ask your vet to show you the thumb test again and ask him how he'd hit the spine from there....

 

The shots worked wonders for Rex and didn't seem to hurt him as he never flinched or yelped. He went from barely being able to get off the couch and having trouble with steps to being a normal dog. His lasted longer than most -- 6 to 8 months and you could clearly see when they were wearing off. To the best of my knowledge oral pred does not do anything for LS.

 

Our shots were given by 3 different vets. One was Dr. Herron but the other two were very agreeable to trying it. They concurred with Dr. Stack that the worst thing that could happen is it just wouldn't work (and sometimes it doesn't). where the thought of hitting the spinal cord came in. Never heard it.

 

The shots worked so well for Rex I never tried anything else for his LS. and he ended up going to the bridge due to a disc that ruptured into his spinal cord between his shoulders so I really can't tell you long term outcome. The shots greatly improved his quality of life for 2.5 years.

 

Best of luck to you and Beck.

 

 

 

 

 

[Guest sbgreymom]

You have all had such helpful ideas - thank you so much! I've been really lucky in my time with Beck, in that his veterinary needs have been fairly straightforward (well, except for the random fractured metacarpal - that threw the vet for a loop), so having to hammer away at a vet over this is a little new to me. I do it all the time with my own doctors though; not sure why we expect vets to be more omnipotent, after all they have so much to keep in mind

 

I'm going to call my vet back tomorrow and get some more discussion going about the depo shots, because I just don't see that the other treatments he wants to try have any kind of success rate, either from the stories on this board or from my Internet research. Beck's appetite is being affected, and he's not a fat hound to begin with. I just don't want to screw around with ineffectual treatments when there's a proven fix out there!!!

 

Sorry, venting. So many of you have been there, done that.

 

Thank you for the pep talks and additional info. Is Dr. Stack's website the Comcast one that the LS info is found on? I'd hate to have my vet bother her, but if it comes to that, is her clinic's info on the Greytalk Vet List pinned on the Health & Med Board homepage?

 

And lastly... Batmom - Reko dogs are the best! I'm so biased though. I was lucky enough to tour their racing kennel one time and have never had so many doggy hugs and sloppy doggy kisses. Good personalities - there were a dozen or so Mo Kick babies in the kennel at that time, but I don't recognize the names of yours. Neat that your Batman was Beck's distant relative though - the first I think I've ever run across online!

[kikibean]

I had a foster for almost a year who has LS and had to get the shots. He was really compromised by the time we got him, so what is good for him still looks terrible to people who don't know him.

 

We had him at the specialist when he first came to our group (return from a group no longer around). He had an MRI, x-rays, etc and all the specialist could come up with was "some instability in the back end" Gee, THANKS for that. I tried discussing LS with him and he totally dismissed me. I finally took him to my vet who, even though he didn't think it would work, agreed to give it a try. Benji did great on the shots, and even managed to get himself adopted to a family who thinks his personality is worth the $30 shots every three months or so. Before she adopted him she gave all her info to her vet to make sure he was OK w/ the shots.

 

When we first did the shots we did the Adequan with it and I gave those shots at home. We finally stopped with that because the Adequan wasn't really making a difference to him.

 

I'd find another vet. The specialist also wanted to do oral pred, which I didn't see the point of.

 

Kelly

[ahicks51]

Thank you for the pep talks and additional info. Is Dr. Stack's website the Comcast one that the LS info is found on? I'd hate to have my vet bother her, but if it comes to that, is her clinic's info on the Greytalk Vet List pinned on the Health & Med Board homepage?

 

Her email address is at the bottom of this page (which also references her other works):

 

http://www.greythealth.com/

 

local.google.com gives her clinic's information thusly:

 

Ironwood Veterinary Clinic: Stack Suzanne DVMAddress:

Unverified listing -

Rated 5 out of 5 3 reviews - more info »

Placement on map is approximate

2632 S Avenue B

Yuma, AZ 85364

(928) 726-5432 - call

 

Doesn't appear she's in the pinned list of greyhound vets.

[Guest Spiff]

I was asking the same sorts of questions earlier this year! Here's a link to a survey that you might be interested in: LS Survey

 

When I asked our vet about the shots, he was receptive to it. He did insist on doing it very carefully, by shaving a small area on Spiff's lower back and sterilizing the skin with betadine. Perhaps your vet is unsure about the treatment because he hasn't tried it before?

 

It's been about 3.5 months since Spiff's first shots and I think it's about time for a new round. His rear starts to sink again when he's standing in one place for a while! At any rate, the shots have been quite helpful - he went from knuckling over and stumbling on a regular basis to being able to walk normally.

 

Good luck!

[turbotaina]

Dr. Stack told me that most new vets are very reticent to try depo-medrol because they are all taught the "horrors" of it in vet school. It is generally used on cats and rarely on dogs. Your vet should know that the amount used is minimal and that the only adverse side effect for an amount that small is that if your dog is prone to pancreatitis, it can trigger an attack. Dr. Stack also told me that pred isn't effective with LS.

 

Good luck!

[Guest sbgreymom]

Not that I expect everyone to follow this post but... here's the latest. Just got off the phone w/ my vet (who I think is soon-to-not-be-my-vet!!) - I told him the Previcox (NSAIDS) weren't working whatsoever and that we need to do something more. He wants to send the x-rays out to a radiologist to be read... I asked him point blank, if this is LS, you can't see it on xrays anyways, right? And he didn't have much answer, basically what he said is that there's not much ON the xrays to begin with, the radiologist would just be a closer look to try to find something.

 

Well, if I'm reading the article on Dr. Stack's site right, Xrays don't confirm LS at all, only the palpation test/ "thumb test" does. So I asked him if instead of chasing ghosts on xrays, we could try the depo injections first - since Beck fails the thumb test - and get my poor dog some relief rather than throwing my money at who-knows-what... I have four geriatric animals (Beck plus another 11-yo mixed breed dog, a 13-yo mixed breed dog, and a 14-yo cat!) and have to focus on keeping them comfortable above knowing the exact cause, when it comes down to bottom line. I mean, there's always the emergency fund, but... really!

 

So - he's not happy with me (the vet) but he's looking at the schedule to see when today he can get us in for the Depo-Medrol injection. I guess when I offered to go somewhere else if he wasn't comfortable doing it, he decided any money was good money. *sigh*

 

I WILL be switching vets.

 

--on a happier note, today is Beck's 11th birthday! Awesome to have celebrated 7 birthdays with my heart dog - despite a bad night he woke up cheerful and dancing (and falling) with a happy face. Is there anything sweeter than those big soft senior greyhound eyes?

 

P.S. I'm not usually so much of a moaner, I promise! When this little crisis is over I swear I'll be a better contributor... already I am SO grateful for all of you and your support!

[turbotaina]

Aw, Happy Birthday, Beck. Hope you can get some relief soon!

[Hubcitypam]

Dr. Stack told me that most new vets are very reticent to try depo-medrol because they are all taught the "horrors" of it in vet school.

Now I remember that she said if your vet wasn't comfortable with the shots to seek out a vet over 40 years old....

As a point of reference, the shots were $28 plus office call at my vet -- a VCA clinic in Dallas proper.

 

Happy Birthday Beck!

[Burpdog]

Neither my chiropractic vet nor acupuncture vet will give the shot. As they say, all old dogs have some degree of LS.

 

If he (your vet) is uncomfortable with giving the injections, I would not let him do it! Find a vet who is.

 

Sending prayers.

[Guest sbgreymom]

Beck says thanks for the birthday wishes!

 

After arguing two more rounds with my vet... I gave up and made an appointment with someone else for this afternoon.

My (former) vet finally grudgingly agreed to *try* the injections but was insisting that they had to be given under general anesthesia!!! Etc etc etc.

Not worth the energy to try to get across to the guy that greyhounds all across the US are being treated with this protocol every day, in office visits, with good success. Or that it either works, or doesn't, but that there don't seem to be horror stories out there like there are with the NSAID treatments!!

And as someone else said, if he's uncomfortable giving the shot, then he shouldn't give it.

 

*sigh*

So we're off to see another vet - who comes highly recommended and has been around the block many times. I'll bring my paperwork and try not to be abrasive, and maybe Beck's birthday present will be some comfort and hind limb function.

 

You guys all rock!!

Pretend I'm sending out virtual fresh-baked brownies to all.... mmmm....

[Jackandgrey]

I am waiting to hear how this visit went.

[packmom]

My vet had limited experience with the shots but had no trouble trying it. It is not expensive. I took them the Dr. Stack article. Unfortunately we had no success with the Depo shot or pred or NSAIDs.

[Cynthia]

Happy Birthday Beck!

 

And Beck's mom - you're the only he's got, so keep doing what you're doing. It's quality of life we're talking about.

 

By the way, Katie's Depo Medrol last week was $15. (Plus office visit, x-rays to rule out obvious cancer, and a few other doodads).

[Guest sbgreymom]

Finally!

Went to new vet - who was recommended by my best friend as well as by a local GH friend - and he was not only open to all my ideas/info but in fact has an elderly St Bernard with the same hind end symptoms... and has been treating it with... drumroll please... steroid injections and Adequan injections!

 

Nice to be on the same page finally. He's optimistic this will give Beck some relief and hopefully some function back too. If it works well he'll let me give the injections myself - the dexamethasone is sub-Q, no biggie, and the Adequan is IM, in the butt muscle. Save a ton of money. Neither of the drugs are quite as long-lasting as the Depo but his old pooch has been functional and trouble-free for a year on the combo... so I'm willing to go this route, to start with.

 

I'm just SOOOO relieved to have a vet who'll converse on normal terms! Who understands that with a geriatric dog it's not about technology or about keeping perfect liver function or following "the rules" but about doing what works to make the dog's last years as happy and comfortable as possible. He was quite humorous about it.

 

I'll update at the end of the week as to how the injections are working for Beck. I can already tell he's getting pain relief, though, because he's sleeping the first deep, comfortable sleep I've seen him sleep in almost 5 days. So nice to see!

[ahicks51]

I'll update at the end of the week as to how the injections are working for Beck. I can already tell he's getting pain relief, though, because he's sleeping the first deep, comfortable sleep I've seen him sleep in almost 5 days. So nice to see!

 

Nice!

[Guest Spiff]

Good news!!