Medicating For Ls

[Opals_mom]

Eden was diagnosed with LS just shy of a month ago. At the time she was really having a hard time on slippery floors, getting up from her bed and using stairs. We got some Methacarbamol and Tramadol from the vet with instruction for 1/2 - 1 pill of the Methacarbamol per day and the Tramadol if she needed it. The first few weeks I gave her the minimum of the M. and a Tramadol in the evenings. From what I've read and researched LS is quite painful but my sweet old lady is so stoic so I'm not sure if she's in pain and dealing with it or is really feeling better. She's also 12.5 and a lazy bum so I'm not sure if I'm overmedicating her sometimes. There are days when she'll hop around outside and be a happy girl before I give her meds in the morning and some days even with meds she's obviously stiff and uncomfy.

 

We are fortunate and very early in the process and from reading about other dogs - we've got a lot of play in her medications and have more to add if need be. Right now I'm just not sure how to gauge her pain. Is it better to give her the meds like clockwork because I know once pain sets in it's harder to get under control, or should I only give it to her when she seems like she needs it? The only thing that worries me about the latter is that she hardly EVER shows any kind of pain. I feel terrible that she was in so much pain by the time she finally showed her back end was having problems.

 

Anyone have any ideas?

[Hubcitypam]

I did the controversial depo shots for Rex and they were amazing.

[Guest Liz_in_PA]

If you get to the point where you want to try the depo shots, she'll need to be off NSAIDs for a week. At least, that's what my vet said.

[GeorgeofNE]

I didn't know what that methocarbanol was, so I looked it up--it's a muscle relaxer. Tramadol is a good pain reliever, but what LS is typically numbness and nerve pain, and I am not sure how well those things respond to Tramadol. I give my guy Gabapentin and Deramaxx (for overall joint pain) and he is going really well!

[DonnaBehr]

Get in touch with Claudia Presto at The Greyhound Gang and see what she recommends.

[NeylasMom]

We use Robaxin (Methocarbamol) as needed for muscle spasms, which can happen over time from overcompensating for the hind end pain. Zuri typically has them in his groin muscles (upon palpation they feel "crunchy" or if they're really bad he may actually yelp or startle a little) and to a lesser degree in the muscles along his mid-spine. Since he doesn't have them all of the time and it does tend to sedate him, we just use it when I think he needs it. I might just give it on a day when I know we'll be doing more stuff, like taking a hike, as a preventative measure, or if he seems really bad, we'll do a 10-day course. I don't get your vets recommendation to dose once daily. My ortho recommends dosing 3x/day for the best effect, or at least 2x/day (we give 500 mg tabs I think, Zuri is 65 lbs).

 

We're pretty early on and don't think Zuri has actual pain now that we've done PT to get his muscle strength back up, but if we did, I would go to Gabapentin first. Tramadol and NSAIDs may help, but since this is primarily neurologic pain, the Gabapentin makes the most sense. I would start with 100 mg 3x/day.

 

If she's in the earlier stages, keeping that muscle mass up is so important. Hilly walks or PT/underwater treadmill. The less active you are, the more the muscle wastes, the more strain that puts on her hind end.

Edited October 23, 2013 by NeylasMom

[Opals_mom]

Sorry - the methacarbamol is twice daily - not once.

 

She has tenderness along her spine as well and if you give her good scritches behind her ears she kind of relaxes into it and her back end just kind of collapses. That was one of the things that led me to take her to the vet. The other thing was I was scratching her bum and started to do it a little harder and she yelpled and her back kind of folded It's taking her longer and longer to get out of bed and she'll look at me for a second or two while I'm calling her before she'll start getting up.

 

Sick dogs are new to me so I was honestly kind of going along with the vet and then reading on my own. I never would have even thought to request specific medication.

 

I guess I should say she is also not officially diagnosed, though the vet and I believe it's LS, because the vet wanted some specific x-rays first to make it official. The vet wanted to anesthetize her for them but the last time with anesthesia Eden had a really hard time and we'd decided we wouldn't do that anymore. Eden is so skinny the vet didn't feel comfortable putting on her back and doing the x-rays she needed; she said it would hurt her. I've been trying to get weight on her but even with more food and higher calorie food I can't get weight on her, she's barely maintaining, so I kind of feel like the x-ray will probably never happen.

 

So I will for sure talk to our vet about a different medication and I'll start making her walks a little longer to keep her muscles moving. Thanks guys

[Opals_mom]

Would a vet give me medication because I ask even if she seems to be okay on what we're using now? I guess she could do better on something else but would I get the benefit of the doubt?

[Batmom]

If you feel an x-ray would be of benefit, check around for a different vet to do it. Unless your dog is completely terrified (and spastic about it) at the vet, there's no reason she would have to be sedated for an x-ray. Vet should also have a set of pads to help position the dog so her spine isn't bruised or uncomfortable during the procedure.

[greyhead]

http://www.theaec.com/services.aspx?s=More This is a link to AEC in Tacoma, where the rehab vet we've used for two LS greyhounds comes every two weeks (I think) to give treatments. (We see her mostly up in Kent, but we have gone to Tacoma too.) Her name is Patti Schaefer, and she's fully certified in acupuncture and chiropractic in addition to being a licensed vet. She did such a good job with our first LS grey that we didn't even have to use meds for the first three years after he was diagnosed! She's also really helpful with med recommendations and can collaborate with whatever vet is doing the primary treatment. Here's a link to her (rudimentary) web site. I'm not certain, but I think you can make an appointment by calling AEC directly. Just an offering in case you are so inclined.

[Opals_mom]

http://www.theaec.com/services.aspx?s=More This is a link to AEC in Tacoma,

 

That is three minutes from my house and I have actually been there - go figure. Thank you!

[greyhead]

 

That is three minutes from my house and I have actually been there - go figure. Thank you!

 

Yay! I forgot Dr. Schaefer's link, though. It's www.canisport.com.

[NeylasMom]

I guess I should say she is also not officially diagnosed, though the vet and I believe it's LS, because the vet wanted some specific x-rays first to make it official. The vet wanted to anesthetize her for them but the last time with anesthesia Eden had a really hard time and we'd decided we wouldn't do that anymore. Eden is so skinny the vet didn't feel comfortable putting on her back and doing the x-rays she needed; she said it would hurt her. I've been trying to get weight on her but even with more food and higher calorie food I can't get weight on her, she's barely maintaining, so I kind of feel like the x-ray will probably never happen.

 

So I will for sure talk to our vet about a different medication and I'll start making her walks a little longer to keep her muscles moving. Thanks guys

Well while an x-ray might give you additional information, it won't let you definitely diagnose LS either. You need an MRI to do that, although it's not worth it to anesthetize an animal for an MRI as you can generally make a fairly confident dx without it imho. Based on what you're describing it sounds likely that that's what she's got.

 

My suggestion would be to see a specialist, either a neurologist or an orthopedist (preferably go to a clinic that has both). A neurologist probably makes a bit more sense, but I've stuck with my ortho since he's incredibly knowledgeable about both this issue and greyhounds. He does have a neurologist on staff that we can consult with if needed though. Anyway, a specialist should be able to guide you better on treatment options, and also get x-rays without sedation as Batmom mentioned.

Edited October 24, 2013 by NeylasMom

[Hubcitypam]

I vote for the Dr. Herron thumb test over an MRI. Have seen it work several times.

[Opals_mom]

I vote for the Dr. Herron thumb test over an MRI. Have seen it work several times.

 

I have done that, not the cracking part but just the pressure; her back legs just fold and she crumbles. There has been once or twice where I was just scratching her bum and she's yelped. All things that brought me back to LS.

 

I got some Focus Factor yesterday and have added that to her daily medicine routine so hopefully that'll help. On our walk yesterday she was practically dragging me so I kept going then wished I hadn't, lol. It was just too far and we had to stop every-so-often; she would wobble and was knuckling under pretty bad.

 

So along the path we go and I will have a talk with her and tell her to be obvious about her pain BEFORE it's too bad Thanks guys - as always. I'm going to call the clinic by me and see if we can't get in and talk treatment.

[NeylasMom]

I'll start making her walks a little longer to keep her muscles moving. Thanks guys

Oh, I meant to add that longer walks aren't necessarily going to do it, it's hills that build core strength. Flat walks won't help with that at all. But if she's having as hard of a time as it sounds from your last description, you might want to look into physical therapy instead. You can start with gentler at home exercises that won't be so difficult for her and a PT can also do massage and cold laser therapy to help with her spasms.

Edited October 24, 2013 by NeylasMom

[greyhead]

Yup, small hills, and best if you run up them. (Come back downhill, then run back up.) Down can be hard on them, so going slow for that part is fine. Just don't overdo. Oh, and you can't trust them on walks to realize that they have to get home too. But even a half-mile twice a day can prevent further muscle loss. At least, this is what have experienced and/or been told by our docs.

[GeorgeofNE]

NeylasMom has got this covered for you!

 

I took George to a specialist who had done her surgical training at clinic in Jacksonville where many of the good racers are treated. She took x-rays--standing. Took a ton of them an only charged me for 2. No anesthesia. She said he just stood there! She told me the only 100% sure way to diagnose LS is the MRI, which here in my area runs over $2,000 for a dog. I asked the vet if her recommended course of action would vary if she knew 100% versus her very educated preliminary diagnosis, and she said no. Since the only reason you need a 100% sure diagnosis is if you'd consider surgery (which would run at lest $10,000), I saw no point in doing it (even if I had that kind of money to spend).

 

Anyway, she recommended the following: avoid jumping onto and off of things, when possible. Keep the dog slim. Keep the dog muscled. Several shorter walks are preferable to one long walk. Try to avoid zoomies and other spazzy behavior. So we do the best we can, but I'm not going to make him stop enjoying life.

 

The collapsing hind end on ear scritches MAY just be pleasure! George does the same thing, but I've seen plenty of dogs do that! It's a different form of "eargasm."

 

I just found a sore on George's weak leg--between his paw pads. Looks like his toes are scrunching up on his worst leg and one nail has rubbed a sore on his other toe. Poor guy. Not sure how to treat it? Looks almost like he needs a little sponge between his toes to keep them apart. Anyone have any ideas, not meaning to hijack.

[Opals_mom]

Why have we not seen pics of George and The Ebil One lately? I feel like it's been forEVER.

[Guest blueberri]

I'm sorry you're going through this

 

My pup was diagnosed early this year. After dancing around with different pain killers and anti-inflams and steroids, we went with the depot steroid. He was a new pup!!!!! He's just becoming symptomatic again now So looks like he might get yearly shots.