Older Dog With Significant Mobility Trouble

[Guest Whistle]

Many of you know I adopted my Bribz’s (who was my heart dog) littermate last December. His name is Raxley.

 

Raxley had a lot of problems with mobility when he first came to me. After seeing my awesome grey-savy vet, he was started on gabapentin, tramadol, and meloxicam. This combo helped him quite a bit for a while, but he seems to be declining now. I’ve never had a hound live past 9 until him (he turned 11 in April). I’m not quite sure what is normal and what is not for an older dog. Most of the time now he seems to just be hurting all over. He does not want to get up off his bed pretty much ever. It is a big effort to get him to go outside. At the same time, he is still eating fine and wants to go on car rides when I get his leash out.

 

My husband has told me to quit worrying and that he’s just an old dog, but he seems to me recently to be in more pain than hounds I’ve seen suffering from osteo (I've had two of my own). Do people consider letting hounds go when they get to this point? Like I said, I have no experience with this. I don’t want him to be in pain, but at the same time, I think about what my husband is saying and wonder if this is the norm for some old dogs? Am I just being paranoid? I really just don't think so. I'm hoping for input from others who have been here.

 

I should also say I know two of the other dogs from this litter. One of them acts like a puppy. The other has issues very similar to the issues Raxley is having. I lost Bribz (my other hound from this litter) to osteo in 2009.

 

I took a short video of him this morning after just a minute outside. This is typical of him the last few weeks.

 

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Thanks so much for reading.

Edited June 1, 2012 by Whistle

[greysmom]

How much of each drug is he currently getting? It might be possible to significantly increase them, especially the gabepentin and tramadol, to give him some relief. If you're not already you could also add in something for joint support, and either salmon or flax oil, which also has anti-inflammatory properties.

[Batmom]

Has he had any kind of diagnostic workup?

[Guest Whistle]

Here are the meds he is taking:

 

 

Gabapentin 100 mg 1 to 2 capsules every 24 hours (we do 1 pill daily)

 

Meloxicam 7.5 mg ½ tablet every 24 hours

 

Tramadol 50 mg 1 - 2 tablets twice daily (we do 4 daily)

 

 

Yes, he has been worked up with more than one exam, a recent blood panel, and recent x-rays. Nothing worrisome showed up.

[Guest alannamac]

In people, tolerance to narcotics can develop over time so that larger doses are needed to have the same effect.

Perhaps that is what is happening with your pup. Have you checked with your vet to see if higher doses might be

needed to alleviate pain? Just a thought.

It is so hard when they get old to make good quality of life decisions.

[tbhounds]

You certainly have room to increase the gabapentin and tramadol dosage/frequency. Have you considered trying adequan injections??

[Batmom]

Have you considered MRI or even spinal ultrasound?

Edited May 29, 2012 by Batmom

[GreyPoopon]

My internet connection is too slow tonight to watch the video, but I just thought I'd mention that a couple of my old dears have been helped immensely by Methocarbamol (muscle relaxant). Both have hind-end weakness. Edie, who was started on it just recently, was quite wobbly when backing up, and could no longer sit without shaking (she had a natural sit). She is now much more stable and has rediscovered the couch.

[Guest Whistle]

Thank you so much everyone for your replies. I am making notes to discuss with the vet.

 

Batmom: I have not considered either. Do you bring these up thinking of something new and acute that could be going on with him? I am open to anything at this point. His former owner told me he had these same issues for quite a while. It really seems this is just a gradual decline, which has been much more noticeable the last couple of weeks. I have had him 6 months now.

[Batmom]

Beg pardon -- I meant spinal ultrasound. If nothing is showing on x-ray, I would want to look around a little more.

[Guest Whistle]

Beg pardon -- I meant spinal ultrasound. If nothing is showing on x-ray, I would want to look around a little more.

 

This does sound very reasonable, and I will bring it up with the vet. Thank you:-).

[greyhead]

Our Spencer is 11-1/2 (and looks SO much like your guy), taking 200 to 400 mg/day of the gabapentin, and 1-2 tramadol tablets/day depending on how he has been doing. He has been getting acupuncture/chiropractic treatments for the past three years, which have kept him not needing the meds until about six weeks ago. His diagnoses are lumbosacral stenosis (by the Dr. Stack test) and a slipping/arthritic lumbo-throracic disk (by x-ray). Before the meds, he'd started moving and behaving much like Raxley. So I agree with tbhounds that you can probably up that gabapentin for sure, and perhaps the tramadol too. We're about to revisit the possibility of getting a depo medrol shot for him; we had held off on that because we'd understood that those shots only work for about two years, and he was only 8 when the LS became apparent. Some dogs seem to get by very well with a depo shot every six months and don't need other meds. That would be nice, I think!

 

One thing that has been important for Spencer is to get one to two 30- to 60-minute walks per day (60 only if we stop a lot and visit with people). That has kept the supporting muscles good enough to do their jobs. (But his two-mile walks of prior years are too much now. Even though he can complete the walk, he pays for it afterward.) It also matters that his nails are in good trim because otherwise one of his back legs turns outward too much and his stance becomes too wide.

 

Don't know if any of this info has been helpful to you, but I hope so. Let us know how things work out, okay?

 

ETA: On walks, we've started using an assist harness that we got from GT-er Carol Becker. If he needs help, we want to be able to manage it. Carol makes these to fit greyhounds perfectly.

Edited May 29, 2012 by greyhead

[Guest Whistle]

Thank you so much, Mary. They do look alike, and the same age too:-). I have made notes on everything you said. I know our vet is knowledgeable about the meds she put him on and I’m sure she will let me know where we can up them. I will ask about the depo injection too.

 

I have tried to walk and exercise Raxley to build up his muscle tone since he came to me. Unfortunately, he truly cannot handle more than 5 minutes max of walking or even standing.

 

Also, his nails are good. I host M&Gs and do pawdicures on at least 20 hounds a month:-). Somehow my hounds don't get trimmed quite as often as my volunteers hounds do, but I still keep them pretty short:-)

[DaisyDoodle]

Where are you? I would consider getting to see Dr. Radcliffe in Wheeling (vet ortho surgeon/track surgeon for Wheeling), Dr. Couto at Ohio State, or an ortho or neuro vet near you. Problems with gait and balance can be due to any number of problems.

 

I'd also consider chiropractic and/or acupuncture treatment.

[Guest peacehound]

My girl is 10, and almost a year ago, I started her on adequan injections, she gets them every six weeks and so far, knock on wood, it has changed her quality of life so much. She was on deramaxx and tramadol and was limping and not moving much, it was heartbreaking to see her in pain. I took her to OSU for a complete check because my own vet couldn't find anything wrong..she had numerous xrays before OSU. Anyways, the shot worked wonders for her..she walks twice a day, goes up and down steps again and even plays a lot the first couple days after the injection. I just hope it continues to work, she is really enjoying retirement now..she also takes the get up and go greyhound supplements. She seemed a lot like your hound in those pics before the shots..best of luck to you and I hope you find some relief for your beautiful boy.

[JohnF]

My last dog who had an inoperable shoulder injury lived to 14. She was on liquid Metacam/Meloxicam for 8 of those years, but dosed intelligently based upon whether it was an acute week or a chronic week or couple of days. She died of Kidney failure (a common side effect of long term use) but I doubt if she'd have got past 9 without it.

 

Now.... I notice a change in the confidence of your dog when walking indoors compared to outdoors. Any chance of surnburned or sidewalk-burned paws? Anything chemically applied to the back yard? Tender feet will be hell for a dog that alread has arthrits.

 

Time to think about letting the dog go? Not according to the video evidence; hopefully you'll have pleanty of quality time left together. You have a happy hound that is sending you Calming Signals http://www.canis.no/rugaas/onearticle.php?artid=1 "You leave me be please and stop worrying" is what she is saying. Maybe with the vets permission change to Meloxicam liquid and dose like I did with Angel; it might cut 3 months off the lifespan but its not how long but how happy isn't it really?

[DocsDoctor]

I would suggest giving physiotherapy, and/or hydrotherapy a try, if you can.

 

Doc (who will be eleven in August) has been having both for the last month, after compressing a disc in his spine - with some associated neurological damage affecting his right hind leg. Both really do seem to be helping - at his worst he was moving like Raxley in your video, now he is almost back to his old self (leg still a bit wobbly on corners and needs the muscle building up). He'll need to stay on meloxidyl permanently the vet tells me but his dose of tramadol has already been halved and hopefully we can stop that altogether soon.

 

We go to our vet's for the hydrotherapy - she has a water treadmill - and the physio is done here at home by a nice vet physio who also volunteers at our greyhound rescue. So massage and manipulation can be done with him lying on his own bed, she also brings a portable laser machine. She has given us a regime of little exercises to do here at home each day too - only takes a few minutes and again really seems to be helping.

[DesiRayMom]

You've gotten a lot of good advice. I'll just add my 2cents.........IMHO, Tramadol works better every 8 hours instead of every 12.

It seems to wear off completely in 12 hours, then you're back to trying to ease more pain instead of staying ahead of it.

I also believe there's plenty of room to increase the dose. One of my vets will actually go to 10 mg/kg with Tramadol if needed.

 

One other thing, Desi took the vet version of Meloxicam (liquid Metacam) first. It worked well, but due to the high cost, I went for a script to human

pharmacy for the Meloxicam. It seemed to not work nearly as well, I could see a significant difference. YMMV.

 

I know how hard it is to see them hurting. Sending hugs to your handsome Raxley.

[KF_in_Georgia]

My 12-year-old gets one 500mg methocarbamol two or three times daily, and it's been a tremendous help. He has arthritis in his spine. When the arthritis bothers him, he tenses up his muscles, which only makes things worse. (The telltale sign his back is bothering him is that he starts to shake as if he has water in his coat, then he abruptly stops the shake. He starts because his back feels "off," and he stops because it hurts.) The methocarbamol relaxes those tensed muscles. We used to have occasions where he'd yelp when he tried to stand up or lie down. The methocarbamol completely eliminated that--and he's not groggy or dopey.

 

He also takes gabapentin and tramadol, and this trio of drugs behaves nicely together. (He used to take meloxicam, but was having stomach problems with it--even taking it after pepcid. We dropped the meloxicam and it seems the only thing we "lost" by dropping the drug was the stomach trouble.)

 

Talk to your vet about increasing the gabapentin and/or the tramadol. Sam's script for tramadol says 1 or 2 pills, two or three times a day. Unless it's a really bad day, Sam gets 1 pill twice a day. Some dogs start panting (apparently anxiety rather than pain) on higher doses of tramadol, so I only give Sam 1 pill at a time.

 

Recent wisdom from Ohio State is that greyhounds do better on smaller doses of gabapentin administered more often, rather than a big dose once or twice a day. Sam gets his daily 400mg-600mg of gabapentin broken up into three doses (breakfast-dinner-bedtime). Sometimes, if he's gone to bed early and we're getting up early, I'll skip the bedtime dose. This winter, if he seemed to be having a bad day, I'd give a single pill at mealtimes and another single pill in between.

 

Sam's still wobbly on his back end, but he's not in any apparent pain. He sleeps well, and still twists himself up like a pretzel when he wants. He plays with stuffies, and eats everything in sight. In cold weather, he's happier in a lightweight coat. (Coatless, he wakes me up about every 15 minutes to get covered up again. Put a coat on him and we both sleep better.)

 

If you're in the U.S., all these drugs are available at conventional drug stores, where they're cheaper than what's provided by the vet. I have a Walgreen's Prescription Family Savings Card, which saves me a bundle. (The card costs $35; it saves me at least that much money on a single month's worth of drugs.)

[Guest FastDogsOwnMe]

Sorry if I missed it, but have you tried acupuncture or some water/swimming therapy to help mobility and build some muscle? He actually looks in pretty good shape (beautiful, boy, btw)

[MaryJane]

I would probably do some blood work and x-rays maybe a spinal workup - I would also check all those paws for corns. You might just want to get the doggie boots and see if that makes a difference with walking.

 

When he was walking it was looking a bit like favoring his right leg where he would go slower when he had weight on it - I might be wrong though.

 

Otherwise, he looks good so if the vet workup does not show anything I would increase pain medicines.

[krissn333]

Recent wisdom from Ohio State is that greyhounds do better on smaller doses of gabapentin administered more often, rather than a big dose once or twice a day. Sam gets his daily 400mg-600mg of gabapentin broken up into three doses (breakfast-dinner-bedtime). Sometimes, if he's gone to bed early and we're getting up early, I'll skip the bedtime dose. This winter, if he seemed to be having a bad day, I'd give a single pill at mealtimes and another single pill in between.

 

I was going to say the exact same thing.

 

I do massage on Carrie and she's been going for acupuncture treatments since she injured her back a couple of weeks ago. Prednisone, methocarbamol, and acupuncture have made her a new dog. I know that the meds likely did a lot of the heavy lifting in the beginning, but, we're almost completely off of meds now and the acupuncture is really helping to keep her loose and comfortable. Plus, she loves the vet we go to see for that

 

Have you been able to pinpoint what exactly hurts on him? Don't forget about the feet - check the pads for corns, check the toes for injuries, arthritis, etc.

 

Another thing that seems to really relax Carrie is when I brush her when she's laying down...she really likes that

[greyhead]

Hey Kelly! After looking at the video again, I'm noticing an expanse of wood flooring. Perhaps some non-slip rugs, runners, or foam standing pads would make walking easier in the house and increase his confidence a *whole* lot! And then maybe he'd get up and move around more, which would lead to stronger muscles.

 

Also wanted to mention that we vary Spencer's doses of meds depending on how he's doing, as some earlier posters mentioned doing. I'm really thinking and hoping that Raxley could get enough relief from a med increase to improve!

 

He's a very lucky boy to have come to you, I think, and your concern and TLC have already made him better. You know that, but I just thought I'd mention it.

[krissn333]

I was finally able to watch the video...it does look like he's got a little bit of a hitch in his giddyup...right hip area, possibly. Have you considered chiropractic for him? It does wonders for Carrie when she gets a little bit "off."

[Guest Whistle]

Thank you so very much to you all for the kind words and advice. Unfortunately, I have not been able to figure out the multi-quote thing. I am going to try to answer questions below and let everyone know where we’re at now.

 

 

1. Talked to our vet today via email. She has examined him in the last few weeks. We will be upping the tramadol and gabapentin.

 

2. Adequan injections. I’m going to investigate further.

 

3. No sunburned paws. Feet are fine on exam. Grass outside has not been treated with anything. He does have a recurring corn on the left front foot. I keep a close eye on it and hull as needed. I really do not notice a difference in general with how he moves based on where he is and what type of surface he is walking on, with the exception of his symptoms being worse if he has been standing more than a few minutes.

 

4. I will also investigate all of the therapies mentioned here.

 

5. Tramadol. As I said above, we will be upping the dose. I will also space it out to every 8 hours. I will do the same with the gabapentin. (Thanks to Kathy for the tip about the Walgreens savings card. This is where we get the hounds’ prescriptions currently. Hopefully it will save us some $$$ too).

 

6. I have not been able to pinpoint where he hurts exactly. It truly seems like it is all over. It seemed to be mainly be the back end when he came to me in December, but now it is impossible to pinpoint his troubles to any specific area.

 

7. Thanks for the kind words, Mary. I’m going to pick up some rugs and bath mats for Raxley. Our entire downstairs has solid-surface flooring, hardwood and tile. They usually have more beds in their half of the living room than you see in the pics. I was washing them at the time of the video:-).

 

8. I will be reading up on methocarbamol as well.

 

Again, you all are awesome. Thank you so much to every one of you who chimed in here.