Ls And Incontinence.....need Your Advice

[Guest greytexplorer]

Mandy will be 15 years old on July 19. She was diagnosed with LS about 3 years ago.

Now I'm turning to the vast knowledge base of GT.

 

Things we are dealing with:

Mandy will and has voided her bladder while sound asleep. (twice today)

She has pooped while asleep, too. (once today)

She'll poop while walking to the door.

She has LS and it is getting worse, judging by the wobblyness, unsteadiness and knuckling under.

When she fell down the stairs a year ago, my dh put up a swinging baby gate. Mandy can't go up/downstairs anymore.

We live on a very steep hill, so daily walks have been discontinued.

She did the splits in the car the last time I took her to the vet, so car trips are done now only on an emergency/urgent basis.

 

Vet prescribed:

Doxycycline 100mg 3x/day

Tramadol 100mg 2-3x/day

Flexeril as needed

Proin 50mg 2-3x/day

 

Like a d-a, I got out of the habit of dosing her when she started to do better!

I have promised Mandy I will not miss another day of dosing and she will just have to suck it up and take her pills like a big girl.

She is a terrible pill taker. The only thing that works is stuffing them down her throat.

It is a huge hassle and she gives me the stink-eye. =/

 

While re-reading other threads in this forum, I noted other drugs folks have used such as robaxin, gabapentin, adequan, and even fish oil.

What else would you recommend for my sweet girl that might help her ?

 

She has been with us for 8 of her 15 years, and I'm not ready to lose her just yet.

She still barks at me around 7-8 o'clock every night, like I'm supposed to do something, but I have no idea what she's demanding!

She enjoys her mealtimes, will grab a stuffy out of the toy box occasionally, and also loves denta-stix and milkbones!

So she still has some measure of quality of life. She has not given up.

 

I have put a call in to my vet to discuss these issues, and want to be armed with information/suggestions when she calls me back tomorrow.

 

Your thoughts and prayers are coveted and appreciated!!!!

 

~Pat down South

[greysmom]

Does she have a UTI? Is that why the doxy? In the absence of infection, the doxy is probably only making her nauseus. Tramadol is a pain reliever and you have room to up the dosage quite a bit if ncessary.

 

Gabapentin is also a pain reliever but it is really good for nerve pain, and issues regarding nerve impingement such as LS. This has the potential to improve her symptoms more than the other potential drugs you listed. I believe robaxin, adequan, and even salmon oil are more anti-inflammatories - which can be useful, but your girl is probably beyond this now.

[Guest greytexplorer]

Vet told me that a round of doxy can bring relief in the spinal canal if there's any swelling.

So we were giving her doxy to see if it would help, and it really did.

She doesn't have a uti.

 

Thanks for the clarification on gabapentin. I'll definitely ask vet about that.

[Hubcitypam]

Seems like one would use steroids instead of doxy for swelling...

 

Bella did not have LS, and frankly we're not sure what was wrong with her. She would do the splits and fall and have trouble getting up. Vet thinks it was either a brain tumor or swelling in spinal sheath. She was on pred for a while (which of course made the peeing worse) and methocarbam and proin for much longer and did pretty well.

 

I know opinions vary on the depo shots, but they made a world of difference in Rex (who did have LS).

[greysmom]

At least the doxy wouldn't have the side effects of steroids, so that may be why.

 

Depomedrol shots, (I think) is what Pam's boy Rex had. Also worth discussing with your vet.

[Guest greytexplorer]

what's the difference between depomedrol shots and gabapentin?

[Hubcitypam]

Depromedrol is an injected steroid to lower inflammation. In the case of LS it is injected on either side (NOT into the spine). In our case it had none of the problems of oral steroids and the cost was amazingly low - around $30 + office call - and the shots lasted around 6 months. It was easy to see when they were wearing off.

 

Depo has had some bad press in vet schools in the past few years but my vet that just graduated from Ohio State swears by it. His Dad was a vet and he said he's seen it do way more good than harm during the years he grew up at his fathers practice. Dr. Stack always said if your vet balks find an older one. Worked great for us and that is all that mattered to me.

 

http://www.greythealth.com/lumbosacral.html

[brandimom]

No advice but a HUGE thank you for taking such good care of her!

[Guest greytexplorer]

@Brandimom>>>thank YOU for the vote of confidence!

 

@hubcitypam>>>Vet wanted to see if the doxy would work for Mandy. Apparently it's been recently discovered that doxy can help in these situations. If it didn't help, steroids would be the next likely step.

[KF_in_Georgia]

Robaxin (methocarbamol) is a muscle relaxer. It might help if there's pain that makes Mandy tense the muscles in her spine. For Sam, gabapentin and tramadol are dealing well with general pain, but I'm convinced the methocarbamol is what lets him get out of bed every morning.

[NeylasMom]

I would start with adding Gabapentin to her regimen. Dosing should be every 8 hrs, not 12 if possible and you should build up slowly. Dose can go fairly high, for a female greyhound you could easily do 200-300 mg 3x/day (that is not even the max dosage), but I would start with 100 2x/day, then switch to 3x/day, then increase to 200 per dose if needed.

 

If that gives her sufficient relief, great. If not, I would consider adding an NSAID, or getting the steroid injections. You may have to hunt a little to find a vet to do them, but I suspect a really good orthopedist or neurologist (I would look for someone younger) will do it. I suspect you may need the injections given her symptoms, but that's a very uneducated guess at best.

 

ETA: I would also strongly recommend finding a specialist to consult with. A practice that has both an orthopedist and a neurologist who consult with each other would be ideal. If you had a progressive nerve issue in your back, you wouldn't just continue to go to your PCP, you'd seek out a specialist. It's worth doing with our pups for the same reason - our regular vets just can't stay as informed to such the level needed to treat these types of diseases when they have to know about so many issues (not to mention know about them for dogs, cats, rabbits, birds, reptiles, and so on unlike our doctors who just have to know humans ).

Edited June 26, 2012 by NeylasMom

[Burpdog]

I would not use Proin but that is me. She's old and she's going to have sleep turds and oops turds!

 

Chiropractic and/or acupuncture will help a lot regarding the incontinence.

[DonnaBehr]

When my boy had LS, he would go outside could not feel that he had to poop all the time. He would come in the house and then poop as soon as he got inside, which made him feel terrible. This boy never peed or pooped in my house in all the years I had him until his LS got so bad. Very sad.

 

She has a lot going on for a 15-year old. :-(

[Guest LindsaySF]

I agree about adding the Gabapentin.

 

Sophie's vet feels that DES is safer than Proin.

[Hubcitypam]

Sophie's vet feels that DES is safer than Proin.

Can't remember why the vet told me he thought Proin would be better in Bella's case than DES, but he did address that.

[HopeForHounds]

Another vote for gabapentin. Jake would be unable to walk if he didn't take it. Daddy proved that when he forgot to pick it up from the pharmacy when I went away in March. 2 days without left Jake barely able to stand. 1 dose of gabapentin and he was standing, second dose meant he could walk again.

 

Jake also gets a shot of Cartrophen every 3 - 4 weeks. Since that isn't available in the US (at least it wasn't in January) Adequan is very similar. Jake has oops poops way less often for about 2 - 3 weeks after his shot.

 

I have no experience with depomedrol as it is contraindicated for Jake as he has an autoimmune disease.

 

Do you use an assist harness? Jake wears his 24/7 he really doens't need it most of the time, but it makes helping him when he can't get up the steps, or simply can't get up, really easy.

[krissn333]

You've received some excellent advice here so I just wanted to comment on a few things.

 

Seems like one would use steroids instead of doxy for swelling...

 

Carrie has done really well on oral prednisone. She does not have LS but has had some lower back issues and had a stroke a couple of years ago, so she definitely has some neurological issues.

 

I would start with adding Gabapentin to her regimen. Dosing should be every 8 hrs, not 12 if possible and you should build up slowly. Dose can go fairly high, for a female greyhound you could easily do 200-300 mg 3x/day (that is not even the max dosage), but I would start with 100 2x/day, then switch to 3x/day, then increase to 200 per dose if needed.

 

If that gives her sufficient relief, great. If not, I would consider adding an NSAID, or getting the steroid injections. You may have to hunt a little to find a vet to do them, but I suspect a really good orthopedist or neurologist (I would look for someone younger) will do it. I suspect you may need the injections given her symptoms, but that's a very uneducated guess at best.

The gabapentin has made a big difference for a lot of dogs here on GT - and studies out of OSU suggest that greyhounds metabolize it faster than other breeds, so, giving lower doses at more frequent intervals seems to be what works best. Jen is a medication genius when it comes to this stuff. We haven't come to need the steroid injections as the oral pred is working for Carrie, but, I'd be open to trying them for sure.

 

Chiropractic and/or acupuncture will help a lot regarding the incontinence.

Acupuncture and prednisone have really changed Carrie's day-to-day mobility for the better. Which reminds me we're about due for another acupuncture session! Carrie really relaxes during it and it seems like her motor function with that right rear leg (most affected by the stroke) has improved a lot. The first time we went, she was very nervous and in pain, and couldn't even stand on her own if I got her upright and positioned correctly. Now she is hopping around like a madwoman

[kudzu]

Another vote for trying gabapentin. It's cheap & often quite effective. For many it seems most effective if dosed 3 times a day. We've done just 100mg TID with the first dose at night for spinal pain & nerve damage with two of my Greys. That was combined with either tramadol or meloxicam & in some cases both. Meloxicam is for inflammation so your vet may be trying doxy instead. (Had not heard of using doxy for this type of thing. Interesting idea.)

[BluegrassGrey]

would also recommend the assistance harness from God's Greyts- worn 24/7. Would also suggest you keep walking your girl on lead for 5-10 min a day- will keep up some muscle mass to help support her rear end. Also, find some soft water proof pads to keep under her for easy washing. You an also put the twin size vinyl waterproof (human bed) covers to put under her bed covers to protect the insides.

 

I went through this with my Pistol and I miss him dearly.

[Guest greytexplorer]

I am so ashamed of myself for letting her meds go........

I've started her back on her meds, and she is doing better......getting frisky and tearing up her beds.....barking at me for some reason I've yet to figure out

Pretty much the same old Mandy.

I'm very interested to hear what the vet says about adding gabapentin......

 

So many great ideas! If you have more, I'm certainly open to hearing them!

 

Pat

[Guest Flaco25]

My girl at some point was doing really bad....gabapentind and a fantastic chiropractor got her walking again. The chiropractor also showed some things to do at home so we do not have to visit her so much. I notice when she starts walking funny or dragging her legs one or two chiro appointments really help.

 

I am jealous in a good way..very happy for you that have been able to have her for so long.

 

My baby boy only made it it 12, my girl is 10 and I am starting to worry.

 

Best wishes

[Guest galwaygirl]

It's always a good idea to check for B12 deficiency; it causes incontinence, it is common in the elderly and is diagnosed with a simple blood test. And treated with an injection. If your vet balks at the idea, insist!