Jump to content

Aston's A New Recruit To The L S Club :(


Recommended Posts

We took Aston in for a checkup earlier than usual (in April) due to his new reluctance to climb stairs -- same office that we've been going to since we've had Aston (almost 4 years), but a new vet has joined the practice. New vet examined him, with me noting that he has a history of a left-hind limp due to his corn foot -- we went through a few diagnoses with the old vet before I read up on corns on GT, and discovered Aston's. Vet noted that Aston has no muscle atrophy in his "bad" side. He got behind Aston and lifted his hind legs and applied mild traction to Aston's spine, inducing a scream. :( He then applied pressure around Aston's LS joint, and my poor buddy sank. As Aston was standing next to me at the front desk, the vet asked, "Does he always stand like that, with his weight shifted further back on his hind legs? That is a sign of pain." :cry1

Aston has been on methocarbamol / Robaxin for a month now. He was on Metacam for the past month, as well; on the first day of Robaxin and Metacam, when the Metacam was a double/loading dose, Aston was a different dog -- cat-stretched for the first time that I've ever seen, went out on a walk and hiked his leg on the first tree he saw and peed himself OUT -- that has NEVER happened. (looking back -- I'm thinking that the novel effect of the Robaxin might have been why Aston was feeling good? not sure how the Metacam would have helped).
We have always known Aston to be a "picky" pee-er -- would hike his leg a little on a tree here and there on walks, but would mostly squat-pee for short bouts. We started giving him treats when he peed to lessen the "pickiness," which increased the frequency but not the duration of leg-hikes and squats. I mentioned this to the new vet after the first day of medication, and the vet replied saying that frequent squat-pees are a sign of pain (inability to twist the spine). The WHOLE time we've had him, Aston's been doing the squat-pees and standing with a rounded hind end. I didn't know this wasn't normal, and he's been in to see the old vet for every sniffle and wrong step. I feel awful. :cry1

Starting tonight, we're adding 50mg Tramadol and 300mg gabapentin to Aston's meals (2x daily), along with his 500mg Robaxin that he gets 2x daily. Last dose of Metacam was this morning.
I asked for scripts from the vet for the gabapentin and Robaxin, since they didn't have the gabapentin on hand, and the Robaxin/methocarbamol seemed expensive from the vet. Turns out that a 60-day supply of the 300mg gabapentin + a 30-day supply of the 500mg methocarbamol was $22.29 total from Costco's pharmacy, while a 30-day supply of the methocarbamol alone was $45 from the vet. :brick Really?

Anyway. Here's hoping the gabapentin and Tramadol help buddy. He's squat-peeing almost all the time now. :(
He still has bouncy-time when we get home from work, and gives Dad a hard time if Dad tries to taunt him with his toys. Hoping we get to see more of that soon... :heart

Link to comment
Share on other sites

Guest FawnFan

Sorry to hear about Aston's issues. I hope he gets some relief soon. This is a bummer.

 

Also good to know about Costco's Pharmacy. I've been buying my osteo pup's drugs at the Vet. My guess is your 60 day supply of 300mg gabapentin was much less than the 15 (pills) I paid $12.35 for yesterday (yes, that's $.82/pill). Ugh... obviously Vets make oodles of money on the meds. Good to know though. Need to learn to call around for the best prices.

 

Again hoping Aston's condition improves soon.

Link to comment
Share on other sites

Glad the new vet could give a new perspective. And hopefully help sweet Aston. But absolutely no guilty feelings. Really. These stoic dogs really make it hard to guess what they're feeling. Even your old vets couldn't nail it. A fresh perspective is what he needed - and he got it. And now prayers and healthy thoughts coming for your boy. Hugs for you :grouphug

http://i57.photobucket.com/albums/g240/mtbucket/siggies/Everyday-2.jpgJane - forever servant to the whims and wishes of Maggie (L's Magnolia of JCKC) and Sam the mutt pup.[/b]

She's classy, sassy and a bit smart assy.

Link to comment
Share on other sites

You might want to go to a neurologist -- my regular vet was sure my Larry has an LS problem and I went to one neuro (exam fine) and the regular vet wanted a second opinion, so I went to a second neuro she recommended and that neuro also said exam fine, not LS. Larry does have some muscle atrophy, more on one side than the other and also has corns on two feet.

 

It might be LS in your case but, sometimes regular vets are not quite up to snuff on neurological conditions.

 

Also, just reread that your vet lifted both hind legs and applied traction ... neither of Larry's neuros did that. After Larry's exam which include mild pressure on the spine more to feel the spine rather than to elicit reactions (from what I saw), what both neuros spent most of their time doing is watching Larry walk - each one watched for about 5 to 10 minutes. One watched him walk back and forth down a long corridor and the other had him walking in a huge arena.

Link to comment
Share on other sites

Walgreen's has a Prescription Savings Club that costs $35 a year. They promise to refund the money if the plan doesn't save you that much.

 

For Sam (spinal arthritis and other issues): 60 Tramadol (50mg) = $12, 180 Gabapentin (100mg) = $15, and 90 Methocarbamol (500mg) = $28.

 

He takes 4 Tramadol a day ($.80), 8 Gabapentin a day ($.66), 3 Methocarbamol a day ($.93) = $2.39/day. (He also takes Soloxine, Doxepin, Metronidazole, Prilosec, and a probiotic capsule every day, so sorting out his meds is fun. With the additional meds, his pills are costing me about $4/day.)

 

According to the Walgreen's paperwork, the prescription card saves $16 on the retail price of Tramadol, $53 on the Gabapentin, and $5.22 on the Methocarbamol (not sure why so little on this one). We refill the Tramadol every two weeks, the Gabapentin every three weeks, and the Methocarbamol every four weeks (more or less). The Walgreen's is closer to me than any other source (including the vet), has good hours, and I can order reflls online and get a text (and email) when the drugs are ready for pickup. They have a drive-thru window (great if I have a dog in the car), and an Express Pay feature (they have my debit card info on file and can charge the meds to the card automatically--no pin to enter, nothing to sign, etc.). Finally, their prescription card has additional features (earns points with purchases, then points can be used in later purchases; also, I think it's 10% off on Walgreen's brand merchandise with the card).

(Sam gets the 100mg capsules of Gabapentin rather than the 300mg tablet so I can adjust his doses easily without trying to slice up a tablet. Sam gets meds 4 times a day, and he's getting 200mg of Gabapentin each time--with room for one more capsule a day if he's having a bad day.)

15060353021_97558ce7da.jpg
Kathy and Q (CRT Qadeer from Fuzzy's Cannon and CRT Bonnie) and
Jane (WW's Aunt Jane from Trent Lee and Aunt M); photos to come.

Missing Silver (5.19.2005-10.27.2016), Tigger (4.5.2007-3.18.2016),
darling Sam (5.10.2000-8.8.2013), Jacey-Kasey (5.19.2003-8.22.2011), and Oreo (1997-3.30.2006)

Link to comment
Share on other sites

FWIW, Graham was a squat pee-er even before his back end started to weaken. Some boys just do.

 

Sometimes Metacam helps backs, sometimes not. Didn't do a thing for Graham.

 

I hope the new meds make Aston feel better.

Standard Poodle Daisy (12/13); Greys Hildy (Braska Hildy 7/10), Toodles (BL Toodles 7/09), Opal (Jax Opal 7/08)
Missing Cora (RL Nevada 5/99-10/09), Piper (Cee Bar Easy 2/99-1/10), Tally (Thunder La La 9/99-3/10), Edie (Daring Reva 9/99-10/12), Dixie (Kiowa Secret Sue 11/01-1/13), Jessie (P's Real Time 11/98-3/13), token boy Graham (Zydeco Dancer 9/00-5/13), Cal (Back Already 12/99-11/13), Betsy (Back Kick Beth 11/98-12/13), Standard Poodles Minnie (1/99-1/14) + Perry (9/98-2/14), Annie (Do Marcia 9/03-10/14), Pink (Miss Pinky Baker 1/02-6/15), Poppy (Cmon Err Not 8/05-1/16), Kat (Jax Candy 5/05-5/17), Ivy (Jax Isis 10/07-7/21)

Link to comment
Share on other sites

I agree with GreyPoopon--my Sam's been a bend-his-knees pee-er since day one (more than ten and a half years ago); he only lifts his leg if he needs to leave a tall message for another dog. I don't think he's been in pain all that time (he never raced, either, so he never had racing injuries).

 

But Sam does have back pain and wobbly back legs. We can see some disk issues on Sam's x-rays. He's also 13 years old and has been jumping on and off furniture for most of those years, so back trouble isn't surprising. Sam gets four meals a day now--partly to go with meds four times a day, but also so that he's eating smaller meals that he can finish before his back end folds up under him.

 

(By the way, Sam's been a frequent short pee-er all his life, too. Not back pain, though. More his desire to keep some reserve in the tank in case he needs to leave another message on short notice.)

 

By the way, if squat peeing is a sign that the dog's in a lot of pain, how does the vet explain girl dogs? Very few of them lift a leg to pee. Are we supposed to assume that they're in too much pain?

15060353021_97558ce7da.jpg
Kathy and Q (CRT Qadeer from Fuzzy's Cannon and CRT Bonnie) and
Jane (WW's Aunt Jane from Trent Lee and Aunt M); photos to come.

Missing Silver (5.19.2005-10.27.2016), Tigger (4.5.2007-3.18.2016),
darling Sam (5.10.2000-8.8.2013), Jacey-Kasey (5.19.2003-8.22.2011), and Oreo (1997-3.30.2006)

Link to comment
Share on other sites

Thanks for the input!
It didn't occur to me that pain might be a factor until the first day Aston was on Robaxin & Metacam. He was BEND-O-DOG. Haven't seen that since; took him off the Metacam for a day (with the vet's approval) to see how things went, and no difference in Aston's behavior or movement -- in fact, he had an extended playtime session that night. :dunno The Robaxin, however, makes a BIG difference. As soon as I weaned him off (at the vet's suggestion, to see whether it was making a long-term difference), Aston was so tight in his back that he hesitated before taking every.single.step :cry1 He'll be on Robaxin indefinitely. we'll see how things go with the other meds.

The LS diagnosis makes sense to me -- he has been increasingly shaky in his hind end, and began slipping and losing his back end in our house around turns -- even at regular walking speed -- a few months ago (we have laminate and tile -- putting latex-backed bathmats down seems to have stopped this). Aston hasn't had an MRI, but his xray showed an almost-complete disc space collapse on the dorsal side of his LS region, with bony bridging developing directly under that joint.

Edit to add: My main concern is getting Aston's pain under control. If he doesn't respond well to these meds, I'll seek out a neurologist to investigate further. Keeping my fingers crossed, as I just want him to be happy and healthy either way :(

Edited by o_rooly
Link to comment
Share on other sites

Brady has LS. He gets 100 mg of gabapentin with each dose. That way, I have room to up it as needed. He also gets Tramadol, as needed, but so far it's usually only in the morning. He is more stiff then. He also has corn on two feet. Some of these guys can't catch a break! I am also giving him Adaquan injections, which have helped his mobility tremendously. He squats to pee. I have never seen him lift a leg, but I just got him at the end of August and he will be 12 in 2 weeks, so I have no comparison. However, my broken leg girl was a lifter and stood on that broken leg to mark all the time. So, you just don't know!

 

Good luck with him. With proper management, the good times continue to roll!

gallery_16605_3214_8259.jpg

Cindy with Miss Fancypants, Paris Bueller, Zeke, and Angus 
Dante (Dg's Boyd), Zoe (In a While), Brady (Devilish Effect), Goose (BG Shotgun), Maverick (BG ShoMe), Maggie (All Trades Jax), Sherman (LNB Herman Bad) and Indy (BYB whippet) forever in my heart
The flame that burns the brightest, burns the fastest and leaves the biggest shadow

Link to comment
Share on other sites

The squatting thing never seemed odd to me, until that day that Aston did no squat pees and peed himself out on the first leg hike. Just the contrast...

Morning after his first doses of gabapentin and tramadol, and he is spaaaaaced out. Didn't wake us up at 6am sharp for breakfast and a pee. Found him on his couch with his head propped up on the couch arm, eyes wide open and glassy. Took a few seconds to say his name enough for him to focus on me. Had to jingle his leash to get him to slowly get off the couch to be let out back for his morning pee (weird). Ate his breakfast with the usual gusto, then went directly to his stack-o'-beds to lie down. None of his usual post-breakfast face-rub marathon using the side of the couch. Still seems stiff this AM. :(

I actually only gave him 1/2 of the prescribed dosage of tramadol last night and this morning (1 50mg tablet each), to gauge side effects. Vet's office prescribed 100mg 2x daily. The vet said that Aston's dosing would be 4mg/kg, which works out to 136mg. Does that mean Aston can have 136mg max PER dose? It sounds high to me, after reading on many of the osteo dogs on here getting 50mg at a time (albeit it sounds like they get that dose more often).

KF_in_Georgia, I'm going to check into the Walgreens plan -- thanks for the tip! :)

Link to comment
Share on other sites

Is he still getting Metacam?

 

Haven't used gabapentin here. Have used tramadol and know that it can space a dog out pretty seriously. I would probably use a lower dose to start with and give that lower dose more often if needed, rather than giving the higher dose only twice a day.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

Link to comment
Share on other sites

Is he still getting Metacam?

 

Haven't used gabapentin here. Have used tramadol and know that it can space a dog out pretty seriously. I would probably use a lower dose to start with and give that lower dose more often if needed, rather than giving the higher dose only twice a day.

The vet recommended stopping the Metacam if there is no visible benefit, since all it would do at that point is serve to possibly caues side effects; there appears to be no benefit, judging from Aston's movement and behavior compared to pre-Metacam -- aside from the MAJOR improvement on the loading-dose day of Metacam and Robaxin, which disappeared in following days. I weaned Aston off of the Robaxin while he was still on Metacam, and his back muscles locked up the minute the Robaxin left his system, so he went back on Robaxin immediately; I took him off of the Metacam, and no visible difference, at all.

Link to comment
Share on other sites

Morning after his first doses of gabapentin and tramadol, and he is spaaaaaced out.

Gabapentin, tramadol, and methocarbamol are all meds that can cause sedation, so I'm not surprised that he's spaced out with this combo. And starting on 300 mg of gabapentin is a pretty high dose. Unless dealing with severe, acute pain, I usually start large dogs on 100 mg gabapentin every 8-12 hours in the beginning and work up to 300 mg per dose if needed. You tend to see less sedation that way. Even if you stay with the 300 mg, his system should adjust to it, and the sedation/spaciness usually goes away after 1-2 weeks.

 

I actually only gave him 1/2 of the prescribed dosage of tramadol last night and this morning (1 50mg tablet each), to gauge side effects. Vet's office prescribed 100mg 2x daily. The vet said that Aston's dosing would be 4mg/kg, which works out to 136mg. Does that mean Aston can have 136mg max PER dose? It sounds high to me, after reading on many of the osteo dogs on here getting 50mg at a time (albeit it sounds like they get that dose more often).

The typical dose range for tramadol is 2-5 mg/kg every 6-8 hours. So Aston's prescribed dose is well within that range. In cases of severe pain that is not responsive to the lower doses, the literature even lists doses as high as 10 mg/kg every 6-8 hours, but I've never gone that high. While some of the OSA dogs may only be getting 50 mg per dose, most are on at least 75 mg, and some up to 200-300 mg per dose.

Jennifer &

Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On),

Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice

gtsig3.jpg

Link to comment
Share on other sites

I realized about a year ago that Zuri (now about to turn 9) was in the beginning stages of LS. Physical therapy has been helpful for him - the reasoning was that he had lost core strength, which was putting additional stress on the areas that were already weak so we needed in improve that core strength (he had been on rest due to a toe dislocation and once the toe healed, I continued to think maybe his decreased activity was due to the toe still being sore, not realizing it was the LS so we likely got into a cycle where his rest exacerbated things and I thought the changes meant he needed more rest :rolleyes:).

 

The other reason we started PT was because the ortho and PT noticed that his groin muscles and some muscles along his spine to a lesser extent were spasming (again, likely from compensating for the weaker hind end). The PT addressed the groin spasming, but I still notice the muscles along the spine spasming when I apply pressure to varying degrees. He was originally on Robaxin for this and I've recently put him back on it and noticed improvement. FYI, my PT feels pretty strongly that Robaxin is more effective and very safe at 500 mg 3x/day rather than 2 so you may want to consider making that change rather than adding in new meds.

 

I am starting to consider adding Gabapentin, but I agree with Jjng that the dose you were told to start on is pretty high. If I were you, I would actually remove the Tramadol entirely, increase the Robaxin to 3x/day and add in the Gabapentin at 100 mg 3x/day. There's solid evidence that Gabapentin doesn't last in the system 12 hours so twice a day is going to be less effective than 3x/day.

 

If that doesn't completely address his discomfort to your satisfaction, then you could increase the Gabapentin to 200 mg 3x/day or add the Tramadol in at a low dose. I haven't really seen/heard much about using Tramadol for LS myself and given the types of symptoms LS causes it would be my last choice although it's relatively harmless (aside from the potential sedation).

 

That's my two cents based on the research I've done and my own experience.

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

Link to comment
Share on other sites

ETA: How old is Aston? You could consider surgery, but you'd definitely want a neuro/ortho consult to discuss that possibility.

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

Link to comment
Share on other sites

ETA: How old is Aston? You could consider surgery, but you'd definitely want a neuro/ortho consult to discuss that possibility.

Aston turned 10 in January. Was Zuri ever considered to be a candidate for surgery? My vet hasn't mentioned surgery at all.

 

Jen and Jennifer, thanks so much for your input!! Food for thought. During the initial exam, Aston had major muscle spasms along his spine when the vet applied pressure in the LS region. No spasms when I applied some pressure along the same line just now, while Aston's lying down. I'll check him again when he's standing (with cheese on standby!)...

 

Would gabapentin's good effects take a few days to sink in?

 

No oddball anxiety-like effects from the Tramadol thus far, which is good, at least :)

Link to comment
Share on other sites

I've read that gabapentin can take 48 hours to get up to full strength. Another thing to note is that while a larger dose may give more pain relief than a smaller dose, it doesn't give longer-lasting relief.

 

Tramadol's odd effects generally aren't scary. But sometimes they stress out owners because panting and pacing from drug-induced anxiety looks exactly like panting and pacing from pain, so there's a temptation to think the pain relief hasn't kicked in.

15060353021_97558ce7da.jpg
Kathy and Q (CRT Qadeer from Fuzzy's Cannon and CRT Bonnie) and
Jane (WW's Aunt Jane from Trent Lee and Aunt M); photos to come.

Missing Silver (5.19.2005-10.27.2016), Tigger (4.5.2007-3.18.2016),
darling Sam (5.10.2000-8.8.2013), Jacey-Kasey (5.19.2003-8.22.2011), and Oreo (1997-3.30.2006)

Link to comment
Share on other sites

Aston turned 10 in January. Was Zuri ever considered to be a candidate for surgery? My vet hasn't mentioned surgery at all.

 

Jen and Jennifer, thanks so much for your input!! Food for thought. During the initial exam, Aston had major muscle spasms along his spine when the vet applied pressure in the LS region. No spasms when I applied some pressure along the same line just now, while Aston's lying down. I'll check him again when he's standing (with cheese on standby!)...

 

Would gabapentin's good effects take a few days to sink in?

 

No oddball anxiety-like effects from the Tramadol thus far, which is good, at least :)

No, when I saw my ortho to diagnose it, it was just the beginning stages so surgery was definitely not under consideration. The thing is, from what little I've read, surgery has a high success rate depending on how far the symptoms have progressed before doing the surgery. For instance, if the dog already has incontinence issues when you perform the surgery, it's less likely you'll be able to reverse that but the success rates overall for dogs that aren't that far progressed seem good.

 

But I think this is a disease where by the time it gets bad enough that you'd seriously consider surgery, your dog is too old or too far along to be a good candidate. Basically, I never hear about anyone on here doing it.

I may be oversimplifying. Obviously surgery of this nature is very serious and I've only taken a cursory glance at the research, but I'm going to be keeping a close eye on Zuri's progression and getting in for a recheck and new x-rays if I start to see things go downhill again.

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...