Synovitis In The Carpus

[Guest Greytdawgs]

Our beautiful 9 year old grey, Jay is in trouble. He is currently very lame on his left front carpus (wrist). He had this carpus explored 3 years ago and the biopsy came back as a inflammatory synovitis (due to racing trauma). It appears as though his leg is full of fluid (edema) His x-rays show bony changes in all of his phalanges (toes) and some bony changes in the long bones too. It does not appear to be osteosarcoma(which just affects the long bone) Anyway, we started prednisone last week (Nsaids did absolutely nothing) and he was better almost overnight on the high dose. Trouble is, he started urinating like a mad man and he is a big dog...he produces a lot of urine. We started to crate him again because we both work full-time. My hubby loves this dog more than anything but he is ruining our new home, so hubby wants him off the oral prednisone. We are also having a baby in a couple of months and he realistically can't forsee picking up after the dog constantly and changing dirty baby diapers. So I weaned him from the prednisone and he instantly got very lame again, even worse than before. Our veterinarian has bought him alittle time by giving him an injection of depo-Medrol. He had that yesterday and he hasn't had any urine accidents yet. He is still very lame but I can see that some of the swelling has gone down, and he will atleast toe touch today. Another problem is that Jay had an old fracture ofhis right hind limb. It never healed right and so he has extreme difficulty getting around at all on 3 legs. He would never be a candidate for amputation. He tires very easily and must be able to climb 6 stairs in and out of our home. I'm beginning to wonder if we should put him to sleep. He is such a good boy and I want him to get better, but I'm not sure it will happen. Has anyone had a similiar situation?

[Guest luckydog]

Could you get someone to let your dog out during the day while you are both at work?

 

[Batmom]

If you keep him on the pred, the extra drinking/peeing should diminish to workable levels in @ 7-10 days. (Might start at a bit lower dose than you tried before, and work up to the minimum needed for him to be comfy.) So, I don't think the cleanup would be a long-term issue for you. The question then is what quality of life will he have on that regimen, and only you can answer that.

 

Hugs and best luck for your boy.

[Guest Greytdawgs]

I wish we did know a dog saavy peson that could . Unfortunately that is not possible, our closest friends are 30 minutes away and it's really too much for anyone to handle, he needs to be carried in and out because of the stairs, and we have another dog too...we have been letting him out constantly, actually a lot of the accidents occur when we are home too despite all the let outs. I work for a veterinarian and some days I can bring him to work, but not everyday.

 

Thank you for the quick responses. I will descuss trying a lower dose of prednisone with my hubby tonight.

I would still love to hear from anyone with a similiar situation.

Edited January 14, 2009 by Greytdawgs

[Guest Willerton]

I feel your pain. I have a cat with chronic illnesses who is causing significant damage to my house, and I'm in much the same situation with him after 5+ years of caring for his chronic problems. I've been wondering if I should have him put to sleep for probably the past two months. So far, I have decided I can still deal with it. But I have decided that before I move to a new place next fall, I will have to put him to sleep because there is nothing more I can do for him medically, and I can't live with another house full of pee/poop.

 

I would let your vet know that you are considering putting him to sleep if this can't be resolved. Maybe the urination problems will be resolved after some period of time on the prednisone. Maybe you could train him to use pee pads if not. But if these and other things don't work, you have to consider both the quality of your pet's life and the quality of your own life.

[CaliforniaGreys]

I could be wrong here, but doesn't the constantly having to pee subside after on Pred for awhile?(10 days or so)

[Guest ChasesMum]

What about looking into a doggy daycare facility for a couple weeks until the pred runs the worse of its course? When you couldnt take him to work? THere are also for hire dog walkers that might be willing to deal with him for a short amount of time. What about the adoption group? Maybe they can put a shout out for assistance for a couple weeks?

 

Yuk what a terrible situation. Up here in Canada I'd say consider toughing it out a couple months till the baby comes, then you'd be on a year maternity leave... but I know that isnt the case in the US. What does your boss say? Is that the vet Jay sees? If not, maybe he would have a different idea to try?

 

I hear ya on the baby, new house, etc. One of the major factors in us not doing chemo for our amputee is just the logistics. We had a 2yo, we were trying for another baby, we were going to be moving out May 31 and not getting our new house until August, and even at that it would be a 2 storey with laminate, and lots of steep stairs to the yard, mud, etc. It just wasnt fair to him either to expect him to deal with all that. Though its not the same illness, the questioning of what to do, and when is always so similar.

Edited January 14, 2009 by ChasesMum

[Guest Greytdawgs]

CBuds-I think so but we started him at 40 mgs prednisone per day, he is 80 lbs. We weaned him down to 20 mg. once a day and he still was drinking a ton/ peeing a ton. The problem with continuing to wean him to lower dosages is that he gets lame right away. It was only on the high dose of 40 mg. that symptoms improved. And that's when he peed on my mattress, my sofa and my futon! (for some reason he likes furniture for a bathroom! Uggh!) I'm so torn apart by this, why does this have to be happening to my sweet boy? Sorry I'm getting alittle choked up...it's all my pregnany hormones, I guess. Thank you to everyone who has some input. It helps so much.

Edited January 14, 2009 by Greytdawgs

[Guest Greytdawgs]

Chasesmum said: {I hear ya on the baby, new house, etc. One of the major factors in us not doing chemo for our amputee is just the logistics. We had a 2yo, we were trying for another baby, we were going to be moving out May 31 and not getting our new house until August, and even at that it would be a 2 storey with laminate, and lots of steep stairs to the yard, mud, etc. It just wasnt fair to him either to expect him to deal with all that. Though its not the same illness, the questioning of what to do, and when is always so similar}

 

You are absolutely right. It is all these little day to day occurences that definitely make it a struggle with Jay. We have limited money so hiring a petsitter etc, is really not feasible for us. We can't afford to bring him to a specialist so my boss has been treating him. He is a great clinician but in all his many years of practice he and his associates have yet to see anything quite like Jay's leg.

And as for our living situation, We have a beautiful home, but it is tough for a greyhound with any type of floor phobia, we had to purchase a bunch of carpet runners etc...because our kitchen dining area, bathroom and hall are all ceramic tile on the first floor and he does a banana split anytime he must walk on a hard floor. Right now he spends most of the time in the living room where it is carpetted with a big pile of fluffy comforters and a few dog beds. I guess that's all we can do is keep him comfy and love him.

[September]

As far as to handle the peeing, I've heard many ppl mention laying down tarps. Maybe you could try that??

[ahicks51]

Just a suggestion: stem cells have proven to be useful for some types of musculosketelal and soft tissue injuries. You might contact a vet who offers these modalities and determine for yourself whether the financial outlay is worth exploring whether this would be a viable option for his condition.

 

http://www.vet-stem.com/smallanimal/

[Burpdog]

Anyone you know who will take him? His quality of life sounds like it can be just fine in the right enviornment.

 

If you don't know anyone, perhaps someone here will offer that is closer to you than I.

[Guest greydogluvr]

Anyone you know who will take him? His quality of life sounds like it can be just fine in the right enviornment.

 

If you don't know anyone, perhaps someone here will offer that is closer to you than I.

 

Is this an option the OP would consider? I bet GT could find a way.

[gazehund]

OP, where did Jay come from? Can he be returned back there?

[CaliforniaGreys]

OP, where did Jay come from? Can he be returned back there?

Or maybe there's someone here in your area who can help. One of my girls pees constantly because of Cushings but I have a dog door. If I were closer, I would help.

Edited January 14, 2009 by cbudshome

[MP_the4pack]

Is a dog door out of the question? My girl's on lasix and she drinks and pees a ton as well.

 

And I've had a dog door for 13 yrs without any problems. No critter or burglar ever came in. (but it's saved my butt a couple of times. Yeah, I had to get in thru the dog door).

 

You just need to have the accessed area fenced. (No electronic fences)

 

I used to use a panel that fit into the sliding glass door. I've since moved to a wall model next to the door, under the counter.

 

[Batmom]

CBuds-I think so but we started him at 40 mgs prednisone per day, he is 80 lbs. We weaned him down to 20 mg. once a day and he still was drinking a ton/ peeing a ton. The problem with continuing to wean him to lower dosages is that he gets lame right away. It was only on the high dose of 40 mg. that symptoms improved.

 

You might need to leave him on the high dose for a few weeks to get the inflammation down; after that you might be able to wean him down a bit. Can't do it too quickly. Either way -- maintaining on a high dose or lowering it a bit -- by 7-10 days the drinking/peeing should diminish to at least predictable levels, for you *and* him.

 

Make sure you give something like pepcid or carafate to protect the tummy if you are giving prednisone.

 

Here, if somebody is starting on prednisone, we take them out every 1.5 - 2.0 hours even if we have to wake them up to do it. Then @ 6 hours overnight. But so far anyone who is on the drug for a time does get used to it, at least to the point of going out only @ every 4 hours daytime and being able to make it 8 hours overnight.

 

 

[Guest Greyt_dog_lover]

What about a belly band? I know it is not ideal for long term use, but for the adjustment period until you can guage how many times he needs to go outside, that is if a doggie door isnt for you.

[patricia]

Our Angel Sophia was also on a high dose of pred...the drinking and peeing DOES slow down. Sending prayers for your sweet....sweet baby boy.

[Guest Greytdawgs]

Thank you to everyone with helpful advice. I was really hoping somebody might have some experience with synovitis in the carpus. Because there is significant bony change in the carpus and foot on x-ray we (the vet included) question how long the prednisone will be effective anyway. the advice about the stem cell therapy is very interesting and I will plan to look into that also. Right now,We are carrying him outside about every 2 hours when we are home...and good news...today he has had no accidents! Yahoo!!! )

 

Burpdog- Placing Jay with another family when he can't even walk is absolutely not an option for us. I would be against that for more reasons than one. Most of all Jay loves us and we are his life...and the greyhound rescue we adopted him from has been a wonderful resource for us. With their support even they have said he could not have a better home or care. Being a vet tech helps. )

 

We have decided to struggle through with the prednisone to hope we get to a manageable point and hope he feels better soon. If we can atleast get him walking...maybe installing a doggy door might be an option, but he is still 3 legged (but toe touching)as of tonight. On the plus side he really seems to be enjoying all of this pampering. Thanks again.

Edited January 15, 2009 by Greytdawgs

[duncan41]

Sounds like you are doing everything possible. If steps are a problem, would a ramp be a possibility? I'm not clear on your set up, but if a dog door and ramp combo were workable, they would allow him to get outside when he needed to "go". Jay is sure lucky to have you and Kevin as parents!

Nikki was on the max dose of pred for her last 3 months and although the volume and frequency of urine was unbelievable at first, it regulated itself to almost normal.

[Guest Greytdawgs]

Duncan thank you for the support. It means a lot. I have good news to report today. He is still mildly lame but will bear weight on the leg. We are very happy with this progress!

[Batmom]

Glad he is better today. Sending hugs for the humans and scritchies for your good boy.

[tbhounds]

Ask your vet about adding Gabapentin to his medication protocol.

[greyhndz]

Hi, neighbor. I'm across Bear Brook state park from you, in Pembroke.

 

A few thoughts:

 

As several folks have said, Jay's steroid dose will be tapered, and his urine output will also decrease, so that will get better in the near future. He might just need to remain on a small dose of pred indefinitely to keep him comfortable. I have an iggy with autoimmune polyarthritis who currently is on 4mg of methylprednisolone (has been for months) and her urinary frequency has decreased as her steroid dose was tapered. (Her problem is different from Jay's, as it's immune mediated rather than post-traumatic, so she's on another med to suppress her immune system so we can get her off steroids.)

 

You might also ask the vet about the possibility of using other treatment options, such as Adequan injections, or injections directly into the joint (hyaluronic acid, steroids with a local anesthetic, etc.) Stem cell therapy is quite expensive.

 

Another thought would be adding on an analgesic, such as tramadol or tylenol with codeine to control pain.

 

Wishing Jay and his family lots more quality time together!