Concurrent Ls And Lp,what To Treat.

[Guest 2CNRGR8S]

Please bear with me as this may be long, but I feel that all the information is pertinent. My 13 year old greyhound Allie, who has been with me for 11, has always been healthy, , though a bit of a drama queen. She has always been afraid of veterinarians, and not a good patient. She had started to slow, but considering her age I was not concerned. First she started have problems jumping up on my bed and soon quit trying, she began to strain to get up from lying down. A couple years ago I noticed she was developing symptoms of LP . I am familiar as my first GH had it, had tie-back surgery at 11 and was with me another year and a half. I first noticed her bark changing to a “yap, yap” whenever I arrived home. Loud, labored breathing, heat and exercise intolerance followed, though not severe and not sudden. She is not very active and always preferred the sofa to the yard. She has never been seen by a vet for this condition as I had no intention of treating it unless she got much worse and her fear of vets has only increased over the years. Unfortunately I can’t say which began first. Recently she started dragging her knuckles coming through doorways, “sinking” if she stood in one spot too long and showing other symptoms of pain and rear end weakness. Lots of panting and pacing. Of course it is now July and in the mid to upper 90’s every day which exacerbates the LP symptoms, which are also pain symptoms We had to make a trip to the vet, and it did not go well. Long wait in lobby and in exam room. She was horribly stressed, loud, raspy breathing. Did I mention she has become a fear biter? She has to be muzzled for exams adding even more stress. We survived the visit, though I heard her scream from the x-ray room several times. The findings were inconclusive. Blood work all good, heart looks normal, minimal arthritic changes in spinal area. I was armed with Dr. Stack’s info on LS and booklet on aging greyhounds.

I had already started her on Previcox I had at home from a previous injury. Vet chose to add Tramadol and Gabapentin to Previcox. Now Allie is very suspicious of everyone and everything. The Previcox is chewable, no problem, the Gabapentin caps I can open and mix in her food, the Tramadol, no way. She is impossible to pill in the traditional way as she even bites me now. Tramadol is so bitter she finds it in anything and then will eat nothing, so she doesn’t get her other meds. I have cut up a tab and put it in several tiny capsules, but it is not feasible and I am not sure the medicine helps.

I do not have one particular veterinarian I trust implicitly as I have only lived here a couple years. I decided to change to a vet that has a home visit practice to minimize her stress symptoms and to have a plan for when the inevitable comes. When Allie showed little if any improvement I called him, explained the situation, told him I wanted to try a steroid injection. He seems OK with that but is out of town and can not get here to see her until August 10. He, and every other vet I have approached with this treatment option do not want to give a steroid as strong as the Depo-medro initially in case it doesn’t help.

They also say she has to be off the NSAID’s for at least 3 days before getting steroid shot and she can’t take them after the injection either. I have never heard of any other steroids being used for this, will a different one help? I can’t make them give her depo. The last couple days she has gotten worse, I don’t know if we can wait until the 10th. She is starting to sink not long after standing, lots of panting and pacing at night. Let me stress she is not incontinent, bladder or bowels, she eats fine, stands to eat, but is sinking before she is done eating. She still greets me with a stuffy in her mouth when I get home. Her being crabby is no reason to let her go, hell I am crabby sometimes. I think packing her up in the car to go to the vet in 100 degree temps is a death sentence. I have nothing for an emergency situation for the LP, it wasn’t offered for my first GH and no vet will give it to me W/O seeing her. My first GH did quit breathing once, turned blue and lost his bowels. He passed out and immediately started breathing again. Will not take that risk with her. Then I read here on greytalk that rear end weakness is sometimes associated with LP and improved with tie back sx. I am more than happy to have sx done if it will help her. I am not even sure which to treat now.

I went and saw a vet I used to use whose office is less than a mile from my home today and explained the situation. He is willing to give her a steroid shot first thing Monday morning if she stays off the Previcox till then. (Her last dose was Friday am) It would not be hot yet, it is a small office and he would see her immediately. He also doesn’t want to use the Depo. So please give me your thoughts and ideas, do I wait till the 10th for Home vet, take her to old vet Monday am for shot, the Gabapentin seems to give her some relief, she is taking 100mg 2 times a day, can I increase that? Not really sure how much the Previcox is helping, though I heard one boosts the other effectiveness. So is the panting/pacing/weakness a pain symptom of LS or is the panting and weak rear end caused by the LP? I hate seeing her so uncomfortable, if I could make her feel better with more Gabapentin, I would feel more comfortable waiting till the 10th. I do have some 2mg valium to reduce her stress I could give her on Monday if I decide to take her to old vet, should I give her some? I will stop now, sorry so long.

Diana

[Guest avadogner]

Dianna,

I am so sorry your hound is having such a rough time. My Ava was has LS and our vet told us we only have a couple months left before she is paralysed from her LS. She is has lost all control of her bladder and bowel function and has to be carried on stairs and nneeds help getting onto her feet. It has progressed really fast. She is only 11 and has been with us since she was 18 mo. Sheis my personal therapy dog so loosing her has been doubly hard. We haven't has any issues with LP so I do not have any advice to offer. Ava has been a horrible eater and has been dining in bed for the last 2 yrs. I mix vanilla Ensure and Chobianni Vanilla vogurt in her Grain Free Blue Bbuffalo Salmon. We do digestive enzymes, fish oil and arthritis supplements crushed with a pill grinder. I try to only by the vet versions that are meat flavored. She also has hypothyroidism so we do a variety of meds. She gets a acid blocker 20 min before meal hiddenin cheese and PB. I soak her kibble in the Ensure to soften it which seems to help.

 

Ava used to take Mobic and Tramadol ut when diagnosed with LS, we had to stop the Mobic to be able to give steroids. She takes them hidden in another PB &cheese bit. We had our vet give her a steroid epjdural injection but her LS is so far along it only stressed her out and didn't seem to help. I think having a home visit vet come is a terrific idea. Being on her own turf and not going through the entire stressful process will hopefully make a huge difference in her stress response. If it was Ava, I would have her seen as soon as possible. I am looking for an accupuncturist that treats dogs. I haven't found one yet in our area yet. We are keeping Ava comfortable and happy and taking it day by day. We will have to let her go soon but as long as she is happy, we are good with dealing with her issues.

 

I truely hope your baby will have more time. There are a lot of experienced, helpful people here on GT. I hope you find help with your LP questions. I just wanted to let you know you aren't alone. Watching your beloved friend become ill is really hard. If you ever just need to chat, worry or rant, I am here on GT each day. I will say a prayer for y'all.

Hang in there,

alicia aka Ava &Augie's mum

[Guest d0ggiem0mma]

A friend of mine had a dog with LP & LS around the same age as your kiddo. She is not on GT but is always willing to share her experience. If you would like me to put you in touch with her, please e-mail me: C L 5219 at gmail dot com (just remove all spaces and put the symbols back in!)

[Hubcitypam]

? I can't make them give her depo.

I am so sorry this is happening. I will tell you that Suzanne told me older vets are much more open to depo shots if that might help you...

Edited July 31, 2011 by Hubcitypam

[3greytjoys]

If you don't have a pill gun, it might help(?). I use this type with outstanding success for cats and hounds: http://www.entirelypets.com/pillgun.html

I do have a hound with advanced LP but without the hind-end weakness. There are many others on the following LP forum that have experience with hind-end weakness associated with LP:

 

Subscribe:LP-subscribe@yahoogroups.com or List owner:LP-owner@yahoogroups.com

 

I was given liquid Torbugesic to inject in a dire LP breathing crisis. (Emergency only to relax her enough to get her to the ER for euthanasia.)

 

Hopefully, one of the GT members who is a veterinarian will see and respond to your post. I agree that any required car rides should be limited to very early in the AM (Although, we don't know your state.) If you end up exploring tie-back surgery for Allie, finding a Board Certified Surgeon with whom to consult would be necessary. My heart goes out to you and Allie.

Edited July 31, 2011 by 3greytjoys

[GeorgeofNE]

? I can't make them give her depo.

I am so sorry this is happening. I will tell you that Suzanne told me older vets are much more open to depo shots if that might help you...

 

Exactly what the three vets who refused to give the shots to my dog said too--

 

"You'll have to find an older vet who might be willing to do that." Some folks swear by the shots, but I took George to a specialist, and she will NOT do them--she says that shots next to the spine cannot help with compressed nerves IN the spine, and the risks from long-acting steroid injections far exceed any potential benefit to reducing the swelling next to the spine--which is really all you do with a steroid shot. Oh, and FYI, this vet did her surgical residency in Jacksonville, FL at a clinic that treats many badly injured Greyhounds, and is a Greyhound owner herself. Her specialty is surgery and pain management.

 

George recently started on Gabapentin. It seems to be helping him a lot. He's only taking 100 mg. at this point. You're right, Tramadol is horribly bitter (I take it for my arthritis).

 

I'm sorry you houndie is being hit with two difficult conditions.

[BauersMom]

My understanding is that when you see LP symptoms and LS symptoms, that it's possible that it's not compression of the nerves like a stenosis causing the problem, but nerve degeneration - both the nerve controlling the back leg and the one to the largynx are "long nerves" and the first to show symptoms in nerve degeneration.

 

Has she seen a neurologist? Maybe there's one locally that will do a home visit? Did they do the Stack test for LS?

 

In our case, this is exactly what we had - nerve degeneration- and there was no effective treatment for the back end weakness and she wasn't a good candidate for tie-back surgery. We just had to manage the symptoms.

 

I'm very sorry you are dealing with this.

Edited July 31, 2011 by BauersMom

[Guest greytfulhounds]

Hi Diana,

 

First, where are you located? I am so sorry you are going through this with your hound.

 

I had a hound with LS only.....my vet was very open to Dr. Stack's protocol, did her own research on it & did the Depo shots. The only thing I can tell you is that it seemed to give my girl some immediate help but they do wear off & when she went for additional injections they did not really seem to give her the help the first one initially did.

 

I currently have a hound with LP, he is 13 yrs old. Prior to his tie-back surgery (November, 2010) he had rear end weakness. Almost like you describe with your hound....panting, pacing, rear end sinking to the floor, dragging his feet sometimes. Initially, after the surgery, the rear end weakness/sinking continued but within two months it completely went away. He is a completely different dog....no more sinking to the floor, breathing much better & his anxiety level is not as high as it used to be.....even when he does get anxious now he bounces back much faster.

 

My mom's hound is almost 13 yrs old. She just had the tie-back surgery done in May & what a difference!!!!! Her back end was really bad last summer......they live in Florida so I don't get to see her much.....well, they just came to visit & I can not believe what a different dog she is.....she actually looks younger, no more sinking in the back end, etc.

 

Personally, after reading about your hound, I would try to treat the LP first as I believe that some of the other symptoms are related to the LP. My suggestion to you is to find yourself a good specialty center & take your hound to see a surgeon.....whether you do the surgery or not. I would also find one, good vet, that you can trust instead of multiple vets for regular veterinary care...this way they know your hound & know you......sometimes vets are more willing to do specialty procedures, like Depo shots, if they know you & have known your hound.

 

I just recently took my hound who had the tie-back for his annual wellness exam. The last time he had been there (October 2010) his breathing & anxiety level got so bad while waiting in the waiting room that we had to sedate him to get his breathing under control & bring his body temperature down.....that was when I decided to go ahead with the surgery. This time around, I gave him some Rescue Remedy before going & when we got to the vet we stayed in the van, with the air running until they were absolutely ready for us. Then they brought us in the back door & got us in & out. This visit went extremely well....he got a tiny bit stressed during visit but bounced back beautifully once in the van & I really believe that is a result of the surgery & his airway being less obstructed.

 

Good luck with your decisions & your baby. If I can help in any way, please just message.

[kudzu]

My understanding is that when you see LP symptoms and LS symptoms, that it's possible that it's not compression of the nerves like a stenosis causing the problem, but nerve degeneration - both the nerve controlling the back leg and the one to the largynx are "long nerves" and the first to show symptoms in nerve degeneration.

 

Yes, ditto this. While it is of course possible to have concurrent yet unrelated LP & LS, many of the same symptoms are shared with other lower motor neuron diseases or polyneuropathies (A disease can be either one of those or both.) I'd like to ask some questions if you don't mind.

 

How was the LS diagnosed? Have you tried to confirm that she is actually in pain? You mention you are not sure the Previcox, an NSAID & analgesic, is working. Did the tramadol, an analgesic only, seem to help at all? If so then I'd guess there really is pain involved. You mention the gabapentin seems to help. It is in general thought to somehow calms the nerves. (Probably a poor description but best I can come up with.) It is listed as an anticonvulsant but is frequently used in pain management for relieving nerve pain. If the only thing that is helping her right now is gabapentin then my guess is you are dealing strickly with some sort of neuropathy or radiculopathy. Though that guess is based on personal experience & am likely missing many other possible causes.

 

When did the pacing & panting start in relation to the beginning of treatment with tramadol? How has she reacted to tramadol in the past? Some dogs do not tolerate tramadol well. For those dogs, pacing, panting, whining or some combinations of those seem to be frequently reported. Just wondering if those might be more from tramadol than the LS & LP.

 

The symptoms you describe really did set me to thinking of the various lower motor neuron diseases that can effect the peripheral nerves. If the major symptom is weakness & possibly loss of proprioception rather than pain then I'd guess this is not two unrelated conditions but merely manifestations of one disease. You would really need a neurologist to help you determine that but of course that requires a vet visit. I understand completely why you would wish to avoid that. A private practice neurologist may be willing to come out to your vehicle to examine her. The visits with my dog suffering this type of condition often included an exam outside in the parking lot.

 

The whole point of determining what condition you are dealing with is simply to decide which treatments are more or less likely to help. If you can get an actual diagnosis of what is going on then you may be able to avoid the stress of appointments & treatments that would prove unsuccessful & thus unnecessarily stressful. (You may already have confirmed diagnosis for these two problems, but I am thinking you don't just based on the info in your original post.) Oral steroids can help with several different spinal conditions & also nerve degeneration that results from autoimmune type conditions. Since those types of autoimmune responses often target particular... I think it's proteins but my memory is failing me... they can attack just one type of nerve & nothing else. However, sometimes with dogs with LMDs (lower motor neuron diseases) do not do well on steroids.

 

Getting a precise diagnosis might be impossible but if you can at least narrow down the possibilities you will be able to better ferret out treatments more likely to be of true benefit. If you have more info on what types of exams & diagnostics have & have not been done, please share them. And have she had full CBC & blood chems done lately? What about urinalysis? Any thyroid testing done? Tick diseases would be possible but considering how long this has been going on & the slow progression I am for some reason do thinking that the most likely. (But I'm in accounting so what do I know.)

 

I am so sorry you are dealing with this. It is a very tough situation for both of you & I do know from personal experience how difficult & agonizing it can be trying to determine the best thing for your beloved friend.

[packmom]

Allie sounds exactly like my Abby who is 14. She has always been a little snarky and fearful and is much worse now that she is older. She has both LS and LP and is much too stressed at the vet to make treating either easy. She gets Gabapentin or Tramadol but I really don't think the Tramadol helps. The Depo shots-I have never had a dog that responded to them. Shilo had wonderful results from Acupunture treatments. Would be great to find someone who comes to the house for you. Probably would help with the LP also. Shi had the tie back at age 12 and did really great. I will not put Abby through the strees at her age. Honestly, the 20 minute ride in the car could do her in.

Best of luck in finding something to help your girl.

[Guest 2CNRGR8S]

Please forgive any logistical errors as I am new to forum format. Thank You for your thoughts and ideas. We are in St Louis, MO. now, previously OK

I know I posted a huge amount of information, to summarize, I think my most pressing questions are-

Will any steroid besides Depo help the LS?

 

Can her dosage of Gabapentin be increased from 200mg daily? She is approx 60 lbs.

 

What if I take her out and she has an LP emergency in the car?

This is my main reason for considering going back to the previous vet who is only one mile from our home. Allie does love to go places in the car, but as I said she is suspious of everything now. My last GH crossed the bridge at this vet, (not the LP GH.)

 

I will only have the LP definitively diagnosed if and when we do the surgery. We need as much bang for our buck as possible from every vet visit.

I can't see doing the tie-back without first at least trying the steroids. Our previous surgeon is in OK.

 

What is the protocol for NSAID clearing both before and afte a steroid shot?

 

One thing the Home Vet mentioned to me I had never heard of was some pain management medication of a different molecular structure that could be applied topically, Anybody know anything about this?

 

I am open to any ideas and suggestions, especially where to begin. I am not loyal to any one vet, but getting a new one, or even the old one, to believe a middle aged working class woman could possibly have this much valid medical information about her dog is a job in and of itself and I have not always been successful.

 

 

Here I am going on and on again. I will join the LP list, I believe I was on it with my first GH.

 

thanks

[kudzu]

Please don't apologize. I'm sorry I missed those. Had meant to address some of them.

 

Will any steroid besides Depo help the LS?

 

I cannot really help much with the questions about steroids. Orals such as prednisone & methylprednisolone are prescribed for some spinal problems, primarily as an antiinflammatory. It is usually prescribed with a large initial dose that is gradually tapered off, often done short term for example over the course of 7 days to two weeks. We did try this initially with my dog who had LMND. At the time though we though he may actually have LS or a disc problem. The steroids only made things worse though in part because it required going out to pee twenty-quintillion times. We took him off it early, though still in a tapered dose.

 

Can her dosage of Gabapentin be increased from 200mg daily? She is approx 60 lbs.

 

You should of course consult your vet before changing doses. For comparison sake though, my senior Grey, 65 lbs, with spinal arthritis took 300 mg twice a day. If I remember correctly the dose could have gone as high as 900 mg/day, likely 300 mg 3x/day. Merck Vet Manual lists gabapentin dose as "Dogs: 25-60 mg/kg, PO, divided tid -qid; 100-300 mg/dog, tid." So 60 lb dog would be getting about 600 mg/day at the low end. However, that is the anticonvulsant dose. For chronic pain I don't think it is usually dosed that high. [Note: For humans, the dose is increased incrementally with the first increase recommended at bedtime. Until he body adjusts to the new dose it tends to through off your equilibrium, among other things. So you may notice balance or gait looking strange for a bit.]

 

What is the protocol for NSAID clearing both before and after a steroid shot?

 

What the vet told you matches what I remember. And it is quite similar to the instructions I was given for my own spinal injections so am inclined to think he is correct. You must have some time between them. Tramadol could be used in between for pain, though not inflammation, if your dog tolerates it.

 

One thing the Home Vet mentioned to me I had never heard of was some pain management medication of a different molecular structure that could be applied topically, Anybody know anything about this?

 

Have not investigated this with dogs. However, I use Voltaren gel on an as needed basis. It is a topical NSAID. This stuff is fantastic. Would love it if there was a version for pets. How would you keep them from licking it off? Unless he means something compounded into a transdermal that could be applied in an inaccessible area rather than the site of pain. Sorry, that's really no help at all.

 

Here I am going on and on again.

 

You are not "going on and on" you are seeking needed assistance for your dog. That's what this forum is for. I wish you both all the best.

[Guest MnMDogs]

You're getting a lot of good advice here. The only thing I would like to add is to perhaps request xanax from your vet to give your girl before going in. Hopefully she would take it, and I found that it helped Mork when we would go in. As his LP progressed (before surgery), he would work himself up and really strain to breather while in the waiting room. The Xanax about an hour before helped that.

 

Also, would your girl be less stressed if waiting in the car? We would also request to wait in the car rather than the waiting room. My apologies if you've addressed these questions. Best of luck to you.

[celbee]

Unfortunately, we know exactly where you are coming from as this describes our boy, Faster.

The tramadol does help him-- given twice a day continuously. It doesn't make him drowsy-- no CNS effects that I have been able to notice. We also have him on Cosequin-DS. Our vet is very cautious about the long term use of the non-steroidal drugs (NSAIDs), so we stay away from those except for really bad flare-ups. (Neither tramadol nor the NSAIDs will stop the progression, so I am happy to focus on pain control.)

 

I have nothing to add to the diagnosis discussion.

About the most I can do is pass on our

"Tramadol Tips"

-Put the pills in empty capsules and then put the capsules in something else.

We use the Cosequin-DS that comes in the capsules... so we make new ones each day. If you need some email me

at carol at greyhound fleece jackets dot com and I can share some. You can also ask your local pharmacist if they have any they can sell you (be sure to explain what you want to do with them.

 

-If the tablets or whatever you put the tablets in "touches" the food, it is considered contaminated and you will be lucky if you can get them to eat any of that bowl....

 

-Things to put the capsule in:

--cream cheese

--peanut butter

--feta cheese (not kidding)

--blue cheese (not kidding)

--shredded cheeses -- work it in your hand so that it becomes a mass that you can wrap the capsule in

--American cheese-- half a slice wadded up so you can wrap it around the capsule

Be prepared to change what you put it in. Some of the above still work; peanut butter continues to be rejected. Currently we are on an American cheese kick.

 

Early on, we could bury the tables in the cream cheese, but this quickly stopped working.

Or, if he wouldn't take it, we would put the ball on his food and he would it eat by mistake. See above and "contaminated" food. Stopped working.

I have a colleague who was part of the team working on the development of tramadol. The bitter taste has always been a problem.

 

And, this is a dog-specific trick... but Faster doesn't have many teeth between his molars and canines, so we also hold the stinky cheese in one hand while we are stuffing the capsule in the other side of his mouth towards the back. The cheese distracts him (sort of)-- all you need is for him to start eating the cheese and then the capsule will go down.

 

Spouse and some others are brave and will sometimes just pill him. I am not that brave.

 

Other LS/LP tips:

-We have a fan set up to blow on him and his fave cushion isn't too far from an AC vent.

-Use a harness instead of a collar.

-Make his outside visits SHORT when it is this hot. Early am/ late at night-- you might be able to let him be out a few minutes more.

 

I don't have anything else to offer other than some hugs for your pup. We all just pray that they will let us know when it is time to go. As long as he is still enjoying life and basically happy, he is home.

 

Carol

[Guest d0ggiem0mma]

Like Bauer's mom said- you may be dealing with more of a nerve degeneration problem. My friend' dog, "Toe," had LS symptoms and LP but was diagnosed with a polyneuropathy. For her dog, it started as weakness in the rear and they thought it was degenerative mylopathy but since he went on to develop other nerve issues like the LP, they decided it was probably all related.

 

I'm not sure how helpful the depo shots will be if it is degeneration instead of swelling and I would be nervous to do injections so close to the spine... My friend's dog was managed with physical therapy, gabapentin, tramadol, and rimadyl. She also chose to do the LP tie back surgery. He never became incontinent, but slowly became VERY weak in the rear. Unfortunately Toe went to the bridge a few months ago after he suddenly became very acutely painful one afternoon, but they were able to keep him comfortable for well over 2 years!

[Guest 2CNRGR8S]

Allie seems more comfortable today, I am leaning towards waiting till the 10th for home vet visit.

I have not gotten the Tramadol down her more than 2 or 3 times but noticed seriously increased panting/paceing when I did give it to her.

She has not had any Previcox since Friday morning as I was considering the Monday morning Vet visit/steriod shot. She seems none the worse for that.

Her best times are the first couple hours immediately following her dose of Gabapentin. I do believe it is more weakness than acute pain, as someone suggested. She starts slowly sinking almost immediately upon standing, if she is not moving. She will stand and beg for a treat, slooowly begins to sink, re-adjusts her back legs and continues to stand. She is still happy to eat, go out to potty, etc. I am happiest when she is asleep. I think it is the loud, laboured breathing that is so frightening. When she struggles to breath she seems more interested than usual in anything to eat. It is almost like she thinks she can push down whatever is constricting her airway with food. I am probably reading way more into this than is actually going on. Should I keep her off the Previcox? I am leaning that way unless she takes a turn.

If I wait on the home vet visit, what should I ask him for to treat LP emergency? She is lying here beside me sleeping peacefully. Thank Dog

[kudzu]

If there is no apparent difference without the previcox then personally I'd leave it out. If she seems best after the gabapentin then I would ask the vet for a recommended dose increase on the gabapentin. Here is how it works for me and a friend who recently started on it & is having similar experience. It starts to kick in an hour or so after taking the dose. On a minimal dose it works quite well for 2-3 hours & then slowly wears off. Usually the nerve pain is returning before the 8 hr range. However, on a somewhat higher dose it knocks the pain back enough to cover that 8 hour span pretty darn well. It can even be good for 10 hours sometimes but never, ever to the 12 hour mark. Is it the same for dogs? I have no idea but am betting not. One thing to consider though is the value of uninterrupted sleep. My friend & I can both get by with a lower dose during the day but a double dose at night is a true godsend. Good, restful sleep unintruded upon by pain actually helps relieve pain all day long. It seems the more tired you are the more you hurt.

 

Pain may not be her issue but if gabapentin really is helping then you may be on the right track by asking the vet about a higher dose. I wouldn't be just casually dosing my dog with this on a daily basis hoping it helps. However, since you seem to be seeing some benefit it seems worth a try. She's not my dog. I'm certainly not a vet. So I will not say you should do. Will tell you what came to mind when thinking of it in a "what if this were my dog" perspective. If my dog was only getting 100 mg, 2x/day, and it appeared to help her then I would be sorely tempted to giver her 200 mg at bedtime one night to see if it helps. That's me. I can't tell you why but nighttime is just miserable with nerve pain. Since I am very sympathetic to this issue I would just have to try it. And if that actually helped I would then ask the vet about dosing something like 100mg AM, 100mg afternoon & 200mg bedtime. That's just a suggestion but it does assume she is really having some pain issue that the gabapentin is helping.

 

Hope you can get on track to keeping your girl happy & comfortable for as long as possible.

[Guest 2CNRGR8S]

Thanks, I was leaning that direction. If she continues like this we will stay off the Previcox and she will be good and clear for steroid shot on 10th if home vet recommends.