Asta's Back Issues Not Improving

[AstasMinion]

Three weeks into treating Asta's most recent bad back episode, we're still not getting anywhere. This is her fourth major bout in several months, but it's different than the previous three in that she hasn't been responding to medication/rest and has not rebounded -- or really even progressed much at all.

 

In brief, her symptoms are distinct back pain at two sites, difficulty lying down and getting up, limping when she first gets up (but that goes away as she "warms up"), and occasional hind-end buckling. Some days are better, others worse, none are good.

 

She has started acupuncture and has her third treatment this afternoon. She's also been to the specialists' clinic, where she passed her neurological exam and where the radiologist called her spinal X-rays "unremarkable."

 

Before doing an MRI, we've chosen to continue with conservative therapy to see if she'll improve: She's on supervised rest with confinement when left alone. Meds include Tramadol, Gabapentin, and Prednisone (+ her regular fish oil and glucosamine). In past occurrences of pain, she responded very well to Rimadyl, Methocarbamol, and Tramadol, but this time the first two meds seemed ineffective. So we added Gabapentin at a very low dose Thursday (I saw a slight improvement with that added to Tramadol) and started Prednisone Saturday night after getting bloodwork and urine test results. I realize that the time between starting Gabapentin and Prednisone was short (2 days), but I really feel like she is not responding well to the Prednisone. In between doses, she cycles through phases of lethargy at the beginning (eyes open, but she does not move) and restlessness through the latter part of the 12 hours (pacing, panting, drinking, up and down).

 

Last night she was up every 45 minutes to an hour -- it's 5:30 am, and she's finally in the last 2 hours of her Prednisone dose, and she is sleeping. I'm waiting for the vet's office to open at 8 to see if I should keep going with this current combination or . . . what. Supposing perhaps that the combo hasn't had a real chance to be tested, but I really don't like what I'm seeing so far.

 

Am I making a mistake by not getting an MRI right away?

 

So frustrated that we're not making much of a dent!!

[Guest Furmom]

I would be interested to see what someone who has been through this for a long time with their Grey.

 

Our Bee had similar issues at the end of Feb but with Meds made a full recovery. She is however a little stiffer in the morning and hasn't been up on the bed since - we think she somehow feels her new limitations because she is all together still a happy girl.

[greyhead]

Did Asta ever get acupuncture? I live in your neck of the woods and could help out with a referral if you like. Our Spencer has probable LS (diagnosed without MRI) and has been treated with acupuncture for about two years.

[Batmom]

If you don't see some improvement in a couple days on the new meds, I'd go for the MRI. (Actually, I'd go ahead and do it anyways, but that's me and I suspect vet care in my area is a lot cheaper than in yours.) Three weeks is a long time not to see significant improvement -- I'd want to know what's going on in there.

 

Hugs and best luck.

[AstasMinion]

Greyhead, she has started acupuncture. It's still fairly new (3 treatments), so I'm hoping she'll start feeling the benefits. We go again later today. Our vet recommended Mercer Island and the Cougar Mountain clinic in Issaquah. The latter is very close to us, so that's where we've been going. How was your Spencer diagnosed? Would love to hear details. The neurologist we saw last week put LS at the top of his list but wouldn't give an actual diagnosis. Hoping your baby has benefited from the acu!! I keep hearing great things, so I'm hopeful that it will help with the pain.

 

Batmom, I'm thinking the same thing -- this is too long to go without improvement. I've got a message into the clinic that would do the MRI to talk me through the process a bit more before making that call. BTW, we moved here from Chicagoland, and veterinary care was definitely cheaper there. But we are here now.

[Guest smarthound]

Hi Lisa,

 

So sorry to hear that Asta isn't improving. I agree with Batmom about the MRI. I think it's important to get a diagnosis so you know the best treatment approach.

 

You might also consider having your veterinarian consult with Dr. Couto at Ohio State. They have a Greyhound Health and Wellness program there and offer free consultations. They will review the medical records and make treatment recommendations. Plus, they can help with pain management.

Here's the link to their information.

 

Jan

[Guest MorganKonaAlex]

Could the panting/pacing be a reaction to the meds? Morgan would do the same if he was given Tramadol or any opiate pain med. I didn't figure it out (I thought he was in pain) until I started plotting the timing of his doses and when he was the most restless.

[AstasMinion]

Thanks for the link, Jan! We'll have to consider that if we're not getting better answers soon.

 

MorganKA, yes, I do think that the pacing and panting is from the Prednisone. Vet agreed to take her off that today, so we will wean back off and reevaluate the other meds (Tramadol and Gabapentin) before adding anything else, or not. She's done well on Tramadol in the past, but we'll keep an eye on that now too.

 

We're back from acupuncture and having quiet time.

[Guest smarthound]

Thanks for the link, Jan! We'll have to consider that if we're not getting better answers soon.

 

MorganKA, yes, I do think that the pacing and panting is from the Prednisone. Vet agreed to take her off that today, so we will wean back off and reevaluate the other meds (Tramadol and Gabapentin) before adding anything else, or not. She's done well on Tramadol in the past, but we'll keep an eye on that now too.

 

We're back from acupuncture and having quiet time.

It looks like OSU charges a membership fee now. But you can call or email them and check.

greyosu@osu.edu, (614) 292-3551

 

I'll watch your posts for updates and hope for good news.

[greyhead]

I'll PM you more details if you like. But the short course for right now is Spencer benefited from acupunture and chiropractic adjustments from the very first visit and improved steadily over the first few months then held steady in a good place. He now gets treatments every four weeks but sometimes that seems a little too long. Now, after two years, his right rear leg has started shaking if he has to stand for 10-15 minutes. We're going to start at-home massage for that and will carry a sling on walks in case we ever get into trouble.

 

I don't know anything about Cougar Mountain. Do they know they're treating with acupuncture for probable LS vs. generalized mobility troubles? I ask because it sounds like your vets/neurologist haven't been all that clear with you about what they think. That would make it hard for you to be clear with the acupuncture vet about what was desired in the treatment, I'd think.

 

Just FYI, our acupuncture/chiro vet is Dr. Patti Shafer and we see her at the Family Dog Training facility in Kent. That's probably a bit far for you, plus she only comes up once every two weeks, on Tuesdays, from where she lives in Olympia. Not ideal if one wants treatment for an emergent incident, which makes me a bit nervous at times. (But I feel better now that we have a new ER that's closer than 17 miles away.)

 

If money isn't a huge issue, an MRI might be helpful. How old is Asta? I'm sure you've already said, but I've forgotten. Spencer started treatment at age 7 and was diagnosed tentatively (i.e., without an MRI) by doing Dr. Stack's push test on his back end after I reported that he was tending to fall down if he tried to pivot around on his back legs. He was also stumbling on walks, which I later learned was from knuckling. All that cleared up with what we call "chiropuncture" treatments alone, no meds. We know he still has the problem, but treatment has slowed it down. Meds will come later, I'm sure. (It's complicated because he has IBD; perhaps the immunosuppressant he takes for that has actually helped reduce the LS inflammation.)

 

Well, shoot, I guess I gave the details anyhow, so no need to PM. I'll gladly entertain any other questions you might have, though, and you have our full measure of good thoughts and support.

[Guest smarthound]

Wondering how Asta is doing.

[AstasMinion]

Hi Jan! Thanks for asking -- I meant to come back and update:

 

A local friend put me in touch with a vet practice that works with a Pacific NW greyhound rescue org (they see about 100 greyhounds per month). They fit me in this week, and the doctor I saw has lots of LS diagnosis & treatment experience. Asta had had two normal neurological exams in the past few weeks, but yesterday there was a noticeable change: her back left leg (particularly the foot), the one she was protecting when this latest episode started, did NOT "pass" the reflex test. Her pain level has also gone up a bit.

 

This vet thinks that Asta exhibits many of the characteristic symptoms of LS, but she also thinks it could very well be a disk problem. Before doing an MRI, though, we're trying the Depo-Medrol shot a week from now. She would have done it yesterday if I'd really wanted, but I felt more comfortable waiting until Asta has been weaned from the prednisone she's taking. If the shot does help, then we can feel confident treating for LS. If it doesn't help, we'll do an MRI. And, depending on what all else is going on, we still may do an MRI even if the shot helps.

 

I'm so glad to have connected with this vet since she deals with such a volume of greys and greys w/LS. She doesn't actually disagree w/opinions from our regular vet or the specialist, but her particular take on things really makes me feel better about the context of everyone's opinions and how to proceed.

Edited May 22, 2010 by AstasMinion

[Batmom]

Sounds like you have a good plan! Hoping the Depo-Medrol helps your pupper.

[nyGreys]

Sending prayers.

[Guest smarthound]

Hi Lisa,

 

I was wondering how Asta is doing. It's been a while since the last update.

 

Jan