Possible Lumbosacral Stenosis

[AEB]

All, Kevin just turned 11 in December. He is having mobility issues that are worsening in recent months, particularly the last several weeks. It think he may have Lumbosacral stenosis.

His current symptoms are an increasingly sinking/weak back end when standing still (such as when eating), difficulty rising, difficulty managing his rear legs when getting off of the sofa, shakiness on soft surfaces, knuckling under on occasion (which he is still able to correct), occasionally dragging a rear leg a little, general stiff movement, stiffness in his rear end (trying to turn around he can become somewhat unstable and catch a rear foot).

 

He has complicating factors in the form of front foot issues. Years ago he broke two toes- on on each foot, weight bearing toes- in separate incidents. We learned a lot from the first and the second healed beautifully. He then split the webbing on each front foot at different times. He then developed a corn on one foot about 2 years ago that we have been managing with hulling. But the first broken toe has become very enlarged and arthritic over the past year or two. It is pressing into the adjacent non weight bearing toe and causing a sore that we can never really get to stay completely healed. So figuring out his mobility issues is complicated by the front feet issues.

 

About 3-4 years ago he had issues with urine leakage in the evening. Eventually we threw out the non-supportive beds he loved and made him use supportive beds and that seemed to resolve the issue. In the past six months to year or so, he had occasionally been pooping in the house right after pooping outside. We blamed it on supplements that had aloe or held water and removed them. While that helped, it didn't resolve it. A few months ago we put him on a daily NSAID as he was having the front feet issues and the vet suggested that if his back hurt, maybe he couldn't completely empty when pooping. I also wondered if he was starting to lose his marbles a little. The NSAID seemed to help, along with monitoring him to make sure he poops outside fully before coming in.

 

We are keeping him lean. And we bought him a twin size memory foam mattress so that he has the best support when sleeping at night. In addition to the NSAID already mentioned, Kevin has been getting cold laser treatments over the past few months, usually once a week, and they do seem to help some. He feels better after. We also added Gabapentin this week. We start acupuncture on Tuesday.

 

I feel that he is starting to decline more rapidly and I am concerned about the speed of the decline and the practical aspects of managing a 90lb boy once his mobility becomes truly limited. What other options have you all found to be effective with symptoms like this?

[greysmom]

You're already doing or starting eveyrthing I would have suggested. There's just no cure for old age...

 

The one thing you might look into is amping that toe if he would be OK to go under anesthesia. The surgery itself is fairly basic and recovery time minimal. You'd have to keep very clean and dry bandaging as his skin is really thin and vulnerable - with changes every two or three days, but it could really help his mobility once healed.

 

Do you have some sort of support harness or sling to be able to help him up and getting around?

 

{{{hugs}}}

[Remolacha]

Hopefully the Gabapentin and the acupuncture will help with his pain, front and back. It may take the acupuncture a few weeks to be fully effective. Otherwise, you are doing everything I would do. It is hard to see them get old

[AEB]

Thank you for your reply. I have thought about amputating the toe, but I do worry that it might make things worse given all the other front foot issues. We can discuss with the vet Tuesday. I think the only harnesses we have are too small. We have some things that will work in a pinch. So far he is still able to get around without too much assistance. But we might have to order something for him soon.

 

We bought a pair of booties for him and maybe we can get some gauze to stay between the toes with the booties and maybe that will help some with his front feet. I just don't know what to do for him and it's really disheartening.

[Time4ANap]

We ordered the Help Em Up Harness for Rocket when his issues started. The harness is a little bulky, but based on the experience of others here seems to be worth the investment. We never got to put it on him as he declined rapidly and we had to make the ultimate decision that none of us want to make. Although he was otherwise a happy, healthy 12 (almost 13) year old, we could not let him suffer the immobility and risk of injury due to weakness and made the decision that a day too soon was better than a day too late in his case.

 

We did many of the same meds when Rocket started having issues, except we also did Adequan Injections at home which I feel gave us a couple of extra months with him. Once Adequan stops working or the LS progresses though, the decline can be rather fast. We did not do acupuncture due to Rocket's space issues. He did not like the Vet getting up close and personal although he did love the Cold Laser Treatments.

 

Wishing the best for Kevin!

[EllenEveBaz]

I got a custom support harness from Godsgreyts shop on Etsy when Nutmeg's LS symptoms got worse. There's a notice that shop is temporarily closed, but I would add my vote for a harness, especially with Kevin's size. It didn't bother Nutmeg to wear hers 24/7, and made life much easier for both of us. The harness made her feel light as a feather when I was helping her up.

 

We live in a rural area and don't have cold laser, acupuncture, chiro, etc., readily available. When the meds like gabapentin weren't helping as much, our vet agreed to try depo-medrol shots: http://www.greyhound-data.com/dir/397/Lumbosacral_Stenosis.pdf Within 48 hours, they made a significant improvement. The effect lasted 2-4 months rather than the longer time stated on the site. They worked two or three sequential times, and when the last one didn't help, we said goodbye.

 

It sounds counter-intuitive, and difficult with your boy's foot issues, but try to give him as much exercise as you can. I was trying to limit Nutmeg's activity, but then learned that keeping their leg muscles as strong as possible helps their back. Besides letting her climb the hill in the backyard, when we went for longer walks in secluded spots I would let her off leash, and she got a little extra exercise and much enjoyment from toddling around always near but not leashed to me.

 

Nutmeg never showed urinary incontinence but did have fecal incontinence in her last months. She never seemed to notice. Luckily, she had excellent digestion and picking up her inside turds was an easy cleanup.

 

Nutmeg probably had an extra year of life from all the extra efforts, and it was a good year. We send best wishes to you and Kevin.

[AEB]

Ia appreciate all of the suggestions. Thank you EllenEveBaz, I printed the article from the link for our vet. We will get him a harness- and we have both of the ones suggested here for Gamo, who was much smaller than Kevin is. Gamo did not like the Help em Up Harness. His situation was far more complicated. I'm not sure what would be best for Kevin.

[cleptogrey]

we are in the same boat. gabapentin did not really help nearly 12 year old felix. he's on tramadol and predisone. we started the PRED with a 20 mg dose( felix was down to 60#s from 76#) and reduced it to 10mg daily. my vet prefers this as since it can be stopped in a short amount of time need be.

 

presently we are staying in a second floor apt. with exterior metal stairs. this has been a god-send for going both up and down stairs. https://ruffwear.com/collections/dog-harnesses/products/web-master-harness. also i can quickly pull felix up when he slides under the couch when he dismounts. getting old for these greyhounds is not a graceful experience. we now lift him(it's easy since he is so skinny) in and out of the van. he now sleeps with the harness on. i air him out a couple of hrs a day!

 

his spirits are high and for the first time in months he's starved and eating kibble again! the steroids increased his appetite but this is different. maybe he is rallying. we are waiting for the rear to give way. he either has a UTI, which is a common complication of Presdisone since their immune system is down or the L.S. has started to affect his nerves for his bladder. I started antibiotics today and will know in a couple of days. Yesterday was a piss fest, so, the crate is up and he can no longer be loose when we are gone. it's most definitely safer and easier.

 

as to the stairs i have old towels taped to each and ever riser. it helps and it also keeps the dirt down. a long walk is now around the block since he drags his knuckles and i have been washing bloody blankets non-stop. i'm in a furnished rental for part of the winter. it looks like his paws and pasterns have been run over by a lawn mower.

 

adequan helped when he was 8 and 9 or so, then the L.S. progressed and how much are you going to try? we did chiropractic treatment, tried when he was younger every supplement on the market. lyme and anaplasmosis do not add to the situation.

 

hang in there, you will know...

[smurfette]

We are having the same issue with Andy. The problem is that the nerves are no longer functioning correctly. As a firm believer in a combination of holistic and normal (by lack of other word) therapy I have him on 40 mg Onsior every morning and on a different variety of homeopathic remedies and herbs and oil.

He also gets weekly laser acupuncture. I bought my own laser and learned how to work it.

Andy will be 13 next month and we are from 15 minutes walks last year at this time to 90 minutes walks (only in cold weather because he has laryngeal paralysis, too).

I can explain our therapy plan if you or someone else is interested.

[cleptogrey]

We are having the same issue with Andy. The problem is that the nerves are no longer functioning correctly. As a firm believer in a combination of holistic and normal (by lack of other word) therapy I have him on 40 mg Onsior every morning and on a different variety of homeopathic remedies and herbs and oil.

He also gets weekly laser acupuncture. I bought my own laser and learned how to work it.

Andy will be 13 next month and we are from 15 minutes walks last year at this time to 90 minutes walks (only in cold weather because he has laryngeal paralysis, too).

I can explain our therapy plan if you or someone else is interested.

please explain. are there any other complications that you are dealing with? we tried crating felix last night, he was pretty anxious and uncomfortable so like fools we let him up on the bed. this is the 3rd day of washing everything- mattress pad(thank god it's water proof) included. i am going to look up onsior, mmm....nasid.

i don't know if i hit complications w/ l/s or kidneys, or uti(treating him for that incase), standard urinary incontience(too many other issues to go w/ proin) or Predisone or what? I am going to call my vet tomorrow, i'm not home and really do not want to start up w/ someone new. i am also looking up the IRIS chart: kidney disease graphing. it's now pretty depressing

[AEB]

We are having the same issue with Andy. The problem is that the nerves are no longer functioning correctly. As a firm believer in a combination of holistic and normal (by lack of other word) therapy I have him on 40 mg Onsior every morning and on a different variety of homeopathic remedies and herbs and oil.

He also gets weekly laser acupuncture. I bought my own laser and learned how to work it.

Andy will be 13 next month and we are from 15 minutes walks last year at this time to 90 minutes walks (only in cold weather because he has laryngeal paralysis, too).

I can explain our therapy plan if you or someone else is interested.

 

Smurfette, I would be interested to know how you perform the laser acupuncture and what kind of laser you bought. We bought our own laser too. It's obviously not anywhere near as good as the one at the vet's, but it seems to help (just takes much longer sessions).

 

Cleptogrey, I am so sorry about Felix. You're clearly doing everything that you can for him.

 

Kevin is still managing ok, but I have noticed a more rapid progression recently and more blatant issues. I am trying to head-off whatever I can at the pass and prepare. Our first Greyhound, Sadie, had what I believe was LS. So we have some experience with it. The vet hasn't Dx'd anything yet, but the symptoms seem to fit. Last night he was playful and happy, so hopefully we can buy him time and he will continue to have a good quality of life.

[NeylasMom]

You're already doing most of what I would suggest, particularly the acupuncture and Gabapentin. In addition, you could look into getting an Assisi Loop to use at home. Also, you might look into a supplement called VetriDisc (made by Vetriscience). I didn't know about it when Zuri had LS, but it's been a godsend for Violet's disc issues and I suspect it might help with LS as well. It's worth a shot, can't hurt, might help.

 

I think it's worth considering the toe amp.

 

Oh, and I second the exercise. I wouldn't do off leash, but things that maintain core strength, namely easy hill walks and walking on uneven surfaces. If the new meds, etc help then you could actually look into PT to build some strength back up.

Edited January 13, 2019 by NeylasMom

[Rakete]

"Rheumesser"

https://www.sdrugs.com/?c=drug&s=rheumesser

did wonders to seniors back. 3 injections within a week and many of his symptoms vanished for a while. We did a second course as the symptons slowly came back (standing with a rear like a german shepherd in the show ring, knuckling, signs of severe back pain, climbing up stairs impossible, etc).

 

It does not stop aging, but it helped to keep him going - which helped keeping muscles that keep him going.

 

He was diagnosed LS more or less by sight, did not run full diagnostics as there are many other issues. Did not know where to start and where to stop, but for him the injections made a differnence.

[smurfette]

The idea is to increase the nerves' ability to transport information. So we started with nux vomica c1000. He gets 1 dose per year. Every week he gets conium c30 and hypericum c30. Every day he gets onsior 40mg in the morning and gelsemium LM06 with his meals twice a day. He also gets St. Johns Wort which is the common name for hypericum as tea leeves on his foot.

Hypericum is known to help with nerve damages and even able to heal damaged nerve cells.

 

Once a week he gets his laser session. I don't know the english name of the points so I will give you the original chinese names. You can look them up.

 

(Yao) Bai Hui

Dazhui

Tianzhu

Dazu

Hegu

Houxi

Waiguan

 

I use a Biolas 6 for 6 minutes on each point.

 

 

 

 

For kidney issues look up suc therapy by Heel. It works great with no side effects

[AEB]

Thank you Smurfette. We will see how it goes with the vet tomorrow.

[Hubcitypam]

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

 

The depro shots worked wonders for Rex but newer vets won't give them.

Edited January 15, 2019 by Hubcitypam

[Rakete]

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

 

The depro shots worked wonders for Rex but newer vets won't give them.

Interesting. Depo-Medrol seems to be a Glucocorticoid plus something, just as "Rheumesser".

 

Here in Austria it was like: "Hm...severe back pain in the lumbosacral area...let's try this". 3 shots in a row, worked for about 4 or 5 months till they symptoms slowly came back. Seemed to be somewhat of a standard therapy, as both attended vets (not familiar with sighthounds) used it without hesitation.

[smurfette]

Thank you Smurfette. We will see how it goes with the vet tomorrow.

Keeping you in my thoughts.

[FiveRoooooers]

Depo injections gave Pal tremendous relief for a very long time. We did one side and later we did both. I would have to go back to see what we did when, but the treatments we used over three+ years that gave him relief until his body simply wore out at 14.1 were Depo, Adequan, acupuncture, chiro, and meds including Deramaxx, Tramadol, Gabapentin. He loved his walks, even if it meant getting ready to go, going out the gate and then those few steps to the back yard to enjoy the view.

 

Good luck with Kevin, please let us know what the vet says.

[cleptogrey]

Yes Pam, the newer vets will no ruse the depro. Shots. That's why Felix is taking prednisone now. My vet perfer something that is easier to control. Adequan was great when he was around 9 but the need for more frequent injections crept up pretty quickly. I was getting it wholesale, that stuff ain't cheap.

 

As messed up as Felix is, he was hanging out in the driveway at our rental. One of the many feral cats was noted and he took off after it like a young dog!!! Double tracking (using both rear paws simultaneously) was the motion that gave him a wonderful joy ride. He hasn't lost the will, just the physical ability to sustain walkie. That's the difficult aspect we endure.

[EDL26374]

Our girls Aja (we name our dogs after Steely Dan songs) will be 13 in April. She has been walking gingerly for some time. We thought it was due to corns (which we are treating) but it got worse recently. So we tried pregnizone, then 2 sessions of accupuncture with minimal impact. Tod.ay we did the Depo Medrol injection. Initial reaction is positive so we are optimistic. Hopefully she progresses. We are not ready to send her over the rainbow bridge quite yet.

 

I'll give updates.

[Hubcitypam]

I am lucky that my newer vet that went to Ohio State and grew up at his father's knee would give them. They lasted 4-6 months. Oddly Rex was also my corn dog..all four feet. Wonder if the two things are related?

[AEB]

So Kevin went to the vet last Tuesday and received laser and acupuncture. Since then we also started CBD oil. He does seem to be doing better. I'm not sure which things are helping (the danger of starting multiple treatments around the same time). But we intend to keep doing the laser and a few more rounds of acupuncture (it is expensive at $125 per session). Will keep you all updated.