Lumbar Stenosis Diagnosis

[Guest Liz_in_PA]

earlier this spring, Dash was diagnosed with a strained psoas muscle and treated with tramadol and rymadil until late July when we thought it had healed. He was back to jumping on the bed and had his goofy eyes.

 

Two weeks ago, he stopped bed jumping and stopped following me upstairs to supervise. He stopped eating anything on the floor. If he drops his treat, he leaves it. We raw feed chicken quarters. I have to cut it up in tiny bits for him to eat and put it in his raised bowl. I thought it might be a relapse of the muscle and restarted his drugs. But he was so careful when trying to lie down. The same foot wasn't being used. (rear driver side) Yesterday, we went to the vet practice and saw a different doctor who took Xrays and saw nothing conclusive. He's not righting the foot appropriately. She said neurological deficit. casually said cauda equina. We won't do an MRI as what would it tell us, really? she added a muscle relaxant to the regimen.

 

I read the symptoms of LS and called this morning to the practice and got a message through to a third vet asking for gabapentin. I got message back in ten minutes saying, in essence, if I had seen your dog yesterday, he'd be on it. So phone tag ensued.

 

Now Dash is on 1 rimadyl 75 2 times daily, 2 tramadol 3 times daily, 1 methocarbam 500 3 times daily and gabapentin 300 2 times daily. Isn't that a lot of gabapentin? Isn't the first dose usually 100 once daily?

 

Monday, I'm going to call to see how soon I can get him in to do the depo shots. That's the next step, right? He's a terrible traveler. He stands all the way. Taking him on the 45 minute ride is something we tend to avoid. Will the depo reverse anything? or simply stop the progression where it is? does it always work?

.

According to the stickers, I need to worry about Dash driving. They must know he's an ex-racer.

[o_rooly]

Aston is currently on 150mg Rimadyl (1.5tabs) 1x daily, 500mg methocarbamol 2x daily, 100mg Tramadol (2 tablets) 2x daily and 300mg gabapentin 2x daily (he has always been on this dose of gaba). I've heard that the half-life of gabapentin is short, though, so a smaller dose more often may be better.
Our tipping point with Aston was when he stopped wanting to go "up" -- upstairs, up into the car, up on the couch... took him in early for his checkup, and came out with an LS diagnosis.

Have yet to find a vet around here who's willing to try depo-medrol. His current vet said we'd try pred as a last resort, but that it would likely wreck his cartilage as well as cause muscle wasting. I'm deathly afraid of these side effects, as it is REALLY hard to get Aston to gain mass once lost...

Also note that per the more recent warnings stuck all over Aston's gabapentin bottles, antacids can block absorption of the medication. I used to have Aston on pepcid to cushion his stomach against the barrage of meds, but stopped giving it to him when I read this. Luckily, he doesn't seem to have any tummy trouble.

Hugs and a smooch for Dash

[dante2zoe]

Brady is in the early stages, but also has tendon damage on one leg. He is currently getting 100 mg gabapentin twice a day (I can increase the amount the the strength as needed) and 500 mg robaxin twice a day. He also gets Adequan injections every two weeks. I do that myself. The vet showed me how to do it and I have been administering it for almost a year. That helped, but the robaxin was the best thing for him. He also receives other joint medications and I keep him walking with the crew. He no longer goes up and down the stairs and is comfortable downstairs at night. I was more disturbed by that change then he was.

 

I have tramadol to give if he is really uncomfortable. But, the weather has improved and he is a feisty thing (comparatively speaking) right now.

 

Wishing you the best.

[Hubcitypam]

It just floors me every time people post "no vet around here with give depo medrol shots" - I haven't found one here that won't. Rex had his at 3 different vets - Dr. Herron who was head of small animal surgery at Texas A&M for 32 years, GALT's main vet and my current vet who is a graduate of Ohio State. He went from being unable to get off the couch to bounding up the steps.

[o_rooly]

It just floors me every time people post "no vet around here with give depo medrol shots" - I haven't found one here that won't. Rex had his at 3 different vets - Dr. Herron who was head of small animal surgery at Texas A&M for 32 years, GALT's main vet and my current vet who is a graduate of Ohio State. He went from being unable to get off the couch to bounding up the steps.

Did you notice any side effects from the depo, akin to those of pred? increased thirst/hunger, wasting?

 

The main argument against it here seems to be that if side effects are bad, there's no way to "undo" the depo, since it would remain in effect for weeks, whereas pred could be dosed out slow/small, and stopped immediately to get out of Aston's system if he reacts poorly.

[Batmom]

Also note that per the more recent warnings stuck all over Aston's gabapentin bottles, antacids can block absorption of the medication. I used to have Aston on pepcid to cushion his stomach against the barrage of meds, but stopped giving it to him when I read this. Luckily, he doesn't seem to have any tummy trouble.

 

 

Believe that applies only to aluminum / magnesium / calcium based antacids. *Regular* Pepcid contains famotidine only, which is different from common antacid drugs.

[o_rooly]

 

Believe that applies only to aluminum / magnesium / calcium based antacids. *Regular* Pepcid contains famotidine only, which is different from common antacid drugs.

Ah! Thanks!!

[Batmom]

Pepcid Complete has some of the other stuff in it; it's sort of a combo of Pepcid and Tums/Rolaids/Maalox. Those are the ones that interact with more drugs, including gabapentin. Always wise to check, tho .

[Guest Liz_in_PA]

okay, I feel better hearing all of this. He's really stoned right now. I'm not sure how we're going to transition to him sleeping downstairs.

[galgomum]

Did you notice any side effects from the depo, akin to those of pred? increased thirst/hunger, wasting?

 

The main argument against it here seems to be that if side effects are bad, there's no way to "undo" the depo, since it would remain in effect for weeks, whereas pred could be dosed out slow/small, and stopped immediately to get out of Aston's system if he reacts poorly.

 

Our vet also gives our 14 year old boy Depo shots and what amazes me is the instant relief.

He is a bit more food motivated, may have to go out a bit more, but be honest, wouldn't you be happy about a 14 year old with a healthy appetite?

And even before the shots, who can be months apart, he started to have to go out a bit more.

Because, he is a senior…

 

And there are days, he doesn't remember he went just 5 minutes ago…

 

And those are the one side effects we see.

If there are others, we don't really worry about, the benefits for him out shine the side effects

[o_rooly]

Our vet also gives our 14 year old boy Depo shots and what amazes me is the instant relief.

He is a bit more food motivated, may have to go out a bit more, but be honest, wouldn't you be happy about a 14 year old with a healthy appetite?

And even before the shots, who can be months apart, he started to have to go out a bit more.

Because, he is a senior…

 

And there are days, he doesn't remember he went just 5 minutes ago…

 

And those are the one side effects we see.

If there are others, we don't really worry about, the benefits for him out shine the side effects

I'm not concerned about increased hunger/thirst/urination.. as mentioned above, my primary concern is the wasting and other possible destructive effects that may cause more pain. Aston is visibly back to pre-diagnosis in terms of behavior (bouncy, waggy, does zoomies in the backyard and inside the condo) since we added Rimadyl to his regimen.. however, I'm always on the lookout for other options, especially for down the road.

 

Edit: going to start another thread to find a vet with whom to consult about depo

Edited September 14, 2013 by o_rooly

[Opals_mom]

Perfect timing - we are in the early stages possibly of LS. I am fairly confident from all I've read that's what it is. We just went to vet today and are started on anti-inflams and tramadol as needed. The vet ordered a full blood panel and urine analysis so we can see how she'll last long-term on meds. She's been knuckling over a little here and there for a while but earlier this week she couldn't get her back legs under her and she was MISERABLE at the dog park - which is not like her at all. I read that if you press on either side of the spine in certain spots you can kind of diagnose LS and I found the spots, pressed on them and her back end basically folded. I feel like a bad mom because she's so stoic all the time so I know she's in real pain to actually be showing

 

I love my old lady so we'll do what we need to do. I'm sure she'll be running around like a crazy lady pretty soon

[o_rooly]

Perfect timing - we are in the early stages possibly of LS. I am fairly confident from all I've read that's what it is. We just went to vet today and are started on anti-inflams and tramadol as needed. The vet ordered a full blood panel and urine analysis so we can see how she'll last long-term on meds. She's been knuckling over a little here and there for a while but earlier this week she couldn't get her back legs under her and she was MISERABLE at the dog park - which is not like her at all. I read that if you press on either side of the spine in certain spots you can kind of diagnose LS and I found the spots, pressed on them and her back end basically folded. I feel like a bad mom because she's so stoic all the time so I know she's in real pain to actually be showing

 

I love my old lady so we'll do what we need to do. I'm sure she'll be running around like a crazy lady pretty soon

:heart

 

 

okay, I feel better hearing all of this. He's really stoned right now. I'm not sure how we're going to transition to him sleeping downstairs.

Aston was noticeably (ha!) more lethargic for the first week or so on the robaxin/methocarbamol, and then maybe a bit in the first week or so on gabapentin, but he seems to be back to his "regular" lazy level.

[DocsDoctor]

okay, I feel better hearing all of this. He's really stoned right now. I'm not sure how we're going to transition to him sleeping downstairs.

Just picking up on this - I had this about eighteen months ago with Doc, when the vet told me that because of his back problems he shouldn't do stairs any more. When I said I was worried that he wouldn't settle downstairs on his own, she said 'you know what? Make sure he has a really comfortable bed downstairs, settle him in it with a nice treat, say goodnight, and just go up. Don't fret about it, and he won't - in fact, I promise you that in a month he'll have forgotten that he ever wanted to go up there.' And she was right . I did block off the stairs with a chair for the first few nights, but it turned out that I was much more worried about it than he was!

 

Also - I don't know this is appropriate for LS, but thought it might be worth mentioning that we have found hydrotherapy, physiotherapy, and acupuncture all helpful for Doc's back problems (he is 12 now, and has a compressed vertebral disc space near the junction with his hips, a problem with his right hip too). He did a course of hydrotherapy last year, walking on a water treadmill at the vets - he didn't like it much but it did help build up his hip muscles again. The physiotherapy he still has every so often, from a nice girl who comes to the house, does massage and also some manipulation, and finishes off with some cold laser treatment. She has also given me various exercises which we do every day to help keep his muscles moving. The acupuncture was again done by a vet who came here to the house (very much easier to get the patient to relax and get the full benefit!) - we did a course of six sessions and now she will just come back if he is stiff and needs 'retuning.' He is still on Metacam and Tramadol but the other treatments do help keep him comfortable and active.

[Guest Liz_in_PA]

New Question:

His driver's side rear leg is noticeably cooler than the rest of him. That can't be good. What can this mean? Is there a benign reason?

[o_rooly]

Unfortunately, I'm not familiar with the temperature-difference issue. How is Dash doing today? Is he on aspirin (I checked in on the other thread)?