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Dealing With Pain Management?

February 25th, 2010 Leave a comment Go to comments

Cory is getting close to his 13th birthday, and has some pain issues relating to arthritis and joint inflammation.  We have tried a few different prescriptions, the most recent being Rimadyl.   We have an appointment to see Cory’s vet this coming Monday to see what his other options might be, because the Rimadyl isn’t giving the relief he needs and is causing him nausea.  He still has spunk and energy and wants us to play with him every evening when we get home.  If any of you have any tips to pass along, Cory would be very grateful.

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  • Karlee

    Hey Cory,
    I saw you are on raw, so you know the basics of the gullet and trachea ect for glucosamine & chondroitin, Why not try some Elk Velvet Antler, Rather right from the antler, treats, or actual suppliment pills. I recommend this stuff to everyone with joint pain. It helped my Mother and Grandmother with arthritis, and with my grandmothers rottie. I hope you try this out, it's worth a try. Best to you and your family!

    • Hi Karlee! Thank you so much for your suggestion. We are looking into everything we can do to help Cory with his pain. We actually just got some very exciting test results back from the Vet, as they said that he's actually improved in many critical areas since his last visit several months ago! That gives us hope that he's got plenty more time with us. It's just a matter of helping him manage his pain! Do you know where we can get Elk Velvet Antler?

      • Karlee

        I found some at a Health food Stores around my house, You can also Order them online (http://www.crmr.com/qeva/) I'm not sure the prices but I know it's on the higher end. It's great to hear that he's doing better! I love to hear that a dog in pain is feeling and acting better over time! Hope the best for you all!!

      • Michelle

        Hi Jayson, I am just reading this post now so I do not know where you are in your journey with Cory. I work for Wapiti Labs Inc. and we make premium Elk Velvet Antler products including our Mobility Herbal Formula for dogs. I would be happy to send you a bottle to sample for Cory. Please contact me at michelle@wapitilabsinc.com if you are interested our web page is http://www.wapitilabsinc.com.

        • Michelle

          I apologize, I read that Cory has passed away. I am very sorry that I did not read this prior to posting previous comment. Thank you for sharing your journey with Cory with everyone and helping guide others in the process.

  • Laurie Higgins

    This is going to be long. But I hope it's worth it.

    I don’t even know where to start. But I guess I’ll start by saying, for those reading this blog, that old age is not a disease. And arthritis cannot be diagnosed without x-rays.

    This epistle is directed at all animal owners, not just the writer of this blog. Please take the advice in the vein in which it is given – for the good of the animal.

    Pay attention to what’s normal for your dog. Notice when she’s slowing down or having difficulty with slick floors or going up stairs or drinking more water. Pay attention to all the tiny little details. What is your dog not doing any more? If you catch yourself saying, “Well, he’s slowing down. He must be getting old.” Stop. Figure out why your dog is changing her behavior. If your vet says, “Well, she’s getting old. She probably has arthritis.” Stop. Get another opinion. Get x-rays. Research. Don’t blow it off. Find out why your dog is changing his activity.
    Now for the details:

    Number one: If your dog is over weight, get the weight off! Don’t make any excuses! Get it off and get it off now. Fat adds to inflammation and inflammation leads to arthritis.

    There are many other options for pain relief than Rimadyl. In fact, Rimadyl has long been known to cause digestive upset, ESPECIALLY in Labs. There are other choices, such as: Deramaxx, Tramadol, Gabapentin, Metacam, ascriptin, and probably many more that I don’t know about.

    Arthritis (assuming you have an accurate diagnosis from x-rays) is not just about pain relief or pain management. Adequan injectable is terrific at relieving pain by helping the joints. It is available online for about $100 for 10 ml. You can get it with a prescription from your vet. You’ll save a lot of money buying it online and giving the injections yourself. Follow the directions. There is a four-week loading dose period. Then it’s once a month. However, your dog may end up needing it more often than every four weeks. Once a week is not uncommon.

    Glucosamine/chondroitin – get your dog on a joint supplement with glucosamine/chondroitin and maybe MSM. Research how much your dog needs. Not all products are made equally. Dasuquin and Glyco-Flex III are good products. So is Synovi G3 if it ever comes back on the market.

    Hyaluronic acid (HA) is another good one. Some brands are made specifically for dogs and can be obtained online. Trixsyn and Lubrisyn are two. There are other products made for humans and horses that can also be used. HA is the same.

    Chiropractic and acupuncture are also very good options for helping the arthritic dog. There are chiropractors that are certified to work on animals. There are vets who have been trained in chiropractic and/or acupuncture. Find someone who is trained in one or the other or both. You may have to find two different people. Veterinary acupuncture sites: http://www.ivas.org and http://www.aava.org. Veterinary chiropractic site: http://www.animalchiropractic.org/.

    Rehabilitation is also highly recommended. Rehab technicians or vets can help your dog quite a bit. You can also help your dog at home with little or no equipment and just a little guidance from the rehab tech or vet. Veterinary rehab site: http://www.rehabvets.org.

    Also investigate Chinese herbs. Hindquarter Weakness by Dr. Xie is good for some dogs. Dr. Xie’s products can only be obtained through a vet.

    Homeopathic remedies such as Traumeel and Zeel by Heel, Inc. are also good. Traumeel is for soft tissue problems and Zeel is for joint/bone and arthritis problems. The Heel products can be obtained at your local health food store. They’re sold for humans but can be used on animals. Follow the dose for adults. Do not handle homeopathic products. Put directly into the mouth of the animal, if possible, or put in their food.

    Therapeutic laser is also another tool in the tool box for vets, technicians, and even owners who want to buy their own. This tool promotes healing and reduces pain. Research these things before you decide to buy your own.

    The DVD “Building the Canine Athlete” by Drs. Chris Zink and Laurie McCauley has many exercises for strengthening your dog’s core and hind end. Don’t let the title fool you. It was originally put together for sports dogs, but many of the exercises will help your pet, especially if they have or will have weakness issues. This DVD can be bought online for $40 from http://www.cleanrun.com. You may be able to find it elsewhere as well.

    All dogs carry 70-80% of their weight on their front ends. When the hind end gets weak, they shift even more weight forward. Eventually the hind legs are just dragging along on the ride, not helping at all. The animal is essentially walking on their “hands.”

    Nutrition – vitamin C and essential fatty acids (Omega 3s) are also good with arthritis and the immune system.

    I worked for a rehab vet for over four years. The above is just the tip of the iceberg what I learned in that time.

    In short, don’t sell your dog short. My last recommendation is to find another vet. One who is educated, enlightened, open minded, and up to date on what’s going on in the world of helping animals.

    All of the above applies to dogs post injury, post surgery, and “aging.” Don’t let your dog get too far along down the slippery slope before you decide to help her. Just as we age and need to change our exercise habits, we need to help our animals age more gracefully, too.

    • Karlee

      Laurie,

      “Number one: If your dog is over weight, get the weight off! Don’t make any excuses! Get it off and get it off now. Fat adds to inflammation and inflammation leads to arthritis.”

      Now I'm not 100% sure, but I have been told that Cory is Raw Fed, So i'm guessing he is not over weight but infact very muscular – I haven't seen many pictures but he doesn't look fat.

      This may seem Negitive, but if you are injecting Adequan 4 times a month at $100.00 a pop, That will get extremely pricey fast. For a dog his age and the economy that is around us, I'd probably lean towards a more economical treatment that wont bankrupt the owners.

      If Cory is on the Raw diet, Glucosamine/chondroitin in good helpful levels are easy to acheive. The only supplimenting you'd need is with natural (extremely cheap) Gullets, Tracheas, cartilige ect.

      I completely agree with Chiropractic and acupuncture though, even theraputic swimming can help losin up the body.

      As for your nutrition – You commented on supplimenting Vit C. Dog already produce enough Vit C in their bodies that they do not need to supplimented at all. Fish BODY oil would be nice to add into his diet because that does help with lubercating joints.

      “My last recommendation is to find another vet. One who is educated, enlightened, open minded, and up to date on what’s going on in the world of helping animals.”
      This sort of got to me, You aren't aware of the current situation with their vet (Sorry if this is in one of the older blogs, but I couldn't find it.) You shouldn't assume that their vet is under educated

      “All of the above applies to dogs post injury, post surgery, and “aging.” Not nessesarily, also if you read, he has been having pain problems – so this is at the point where it is happening, it isn't in the future it's now. It's not really just post injury, or post surgery..

  • Pingback: The road back to youth | Cory's Story()

  • Laurie Higgins

    Adequan is not $100 per shot. It's $100 for 10 ml. The dose is subject to the size of the dog.

    As I said, this information was not just for Cory. If some of it doesn't apply to Cory, then it doesn't apply to Cory. I'm just throwing it all out there for whatever it's worth and for whoever is reading the blog.

    What I got from the blog is that Cory is in pain and he has arthritis. That is where I started; that's all I know. Take what you can use and go from there.

  • Sandy DeMers

    Wow, I am really impressed with the passion here. Our dogs deserve nothing less! This is Sandy here posting (I cannot figure out how to sign in as myself, so I’ll be a guest for now).
    Jay and I took most of today off to take Cory to a neurologist, (referred to by his regular vet, who we saw last Monday). The neurologist took a good hour and did a very thorough exam and found three areas that might be improved with surgery or cortisone shots. But first, let me tell you that Cory is not and has never been overweight. That is one of the great benefits of feeding raw.  Yes, he is very muscular, and in his day he was one of the most athletic dogs I have ever known. Cory has taken Glucosamine/chondroitin supplements for at least the past 5 years (maybe longer), every single day. He has received daily fish oil supplements since he was 3 years old. Whether or not he needs it, he gets 500 mg. of Vit. C twice a day. We came home today with a large bottle of Gabapentin, which I see is one of the recommendations for pain relief on Laurie’s list. If it does not help we will try something else. Cory had an x-ray of his chest today to rule out cancer. (Yay!) The vet said that since he does not have cancer the next step is to have him get an MRI to see exactly what the issues are. His right shoulder hurts and his hind legs don't work right, and the vet suspects a herniated disk. I'm thinking we will start him on the Gabapentin tonight and get him into a rehabilitation & aquatic therapy center which is run by a veterinarian (known to and liked by Cory's regular vet as well as the specialist we saw today) starting next Saturday (her first opening). I think the next step will be to get him a few cortisone shots in his shoulder, and maybe after that we'll go ahead with the MRI to see if he has a herniated disk on his lower spine, which the vet thinks may be helped by surgery. Now, Cory is just a few months from his 13th birthday. We, need to look closely at what is really the best thing we can do for Cory. Laurie and Karlee, I can't thank you both enough for caring about Cory and offering to us the benefits of your extensive experiences.

  • Laurie Higgins

    I did forget to mention underwater treadmill and/or swimming. I'm glad to see that you're going that route (aqua therapy).

    The shoulder may be what's called an MSI – medial shoulder instability. In us, we'd call that a rotator cuff injury. There is a specific physical test for it and an MRI won't show it.

    When you say his hind legs don't work right, please describe what you mean. Does his knuckle over or walk on the tops of his feet? Has he been tested for DM (degenerative myelopathy)? Is he weak? Has he splayed out either behind or in front? Has he fallen ever?

    Be careful about back surgery. I know of too many dogs that have had back surgery because x-rays showed something and they came out paralyzed but weren't paralyzed before Sx. The Sx is on the dog, not the x-rays. If he's functioning, I wouldn't risk it. But that's just my opinion.

    An MSI can be helped by hobbling the shoulder so that it cannot splay out. Then rest to let it heal. If necessary, a very specific Sx. There's only one surgeon I could recommend for that and he's in Maryland. He does it arthroscopically using radio frequencies to get it to scar down.

    It could be the elbow.

    Herniated disk – chiropractic and acupuncture, possibly electroacupuncture. This last is dry needles attached to leads from an electrical stimulator.

    Another thing I forgot to mention is aquapuncture injecting B12 or B12 with either Zeel or Traumeel, depending on the condition.

    Some dogs do better with dry needles, some with aquapuncture, some with electro.

    Good luck to you.

    • Sandy DeMers

      Hey Laurie, Sandy here again, (still posting as a guest I see, sigh). The diagnosis is “Suspected cruciate injury on the left rear leg; right shoulder supraspinatus/bicipital tenosynovitis and differentials for the spinal pain include intervertebral disk disease, neoplasia, diskospondylitis, trauma and myelitis….likely a mixture of orthopedic and neurological disease.” Yes, the neurologist mentioned that the shoulder would take a different test than an MRI and said we would basically bring Cory in for a full day of testing. (Yikes!) Yes, Cory does drag his rear legs over his toenails when we are on our walks, just as you described, and yes, he has weakness in his hind end, but he has not fallen, nor does he “splay out.” I greatly appreciate your comments on spinal surgery and what you have personally witnessed. Cory had one acupuncture therapy and it did him no good. He has had many chiropractic treatments and again, nothing discernable afterwards. Yes, the place we have him going does have underwater treadmills. I can't imagine what that is but am excited to see it in action! The vet recommended that I get Cory a harness with a handle so I can help lift his hind end as he goes up and down stairs. I stopped at our local Petco and they don't have anything like that. Can you offer any advice on where I can find one?

  • Laurie Higgins

    One of the best harnesses is called the Hartman Harness. It's found at http://www.hartmanharness.com. There's another one out there that's also quite good, but I can't remember the name of it.

    Acupuncture should be tried at least three or four times in a row about 1 week apart to really see any difference. And, you would also need to try dry needles, dry needles with electro, and aqua acupuncture as I mentioned.

    Get the DVD “Building the Canine Athlete” and start doing the exercises that strengthen the hind end and core.

    DM testing is a blood test drawn and sent in by a vet. It has been and may still be free.

    The test for MSI is a 5-minute physical test done by someone who knows how. I will describe it, but I don't suggest that you do it yourself. Lie the dog down with the good side up. Put the palm of your hand at the elbow and push straight forward toward the eye. Holding the shoulder blade down, abduct the rest of the leg away from the body. Try to assess how much angle you get on the good leg. Now change sides so that the bad leg is up and try again. If it is an MSI, you should be able to tell that there is too much looseness or too much angle or range of motion. However, don't do this yourself.

    If Cory has bone cancer of that leg, it will take a very specific x-ray of the chest to find it.

    It is possible for the cruciate to heal on its own if Cory is kept quiet with no jumping around. And it sounds like he doesn't do that anymore anyway. It is also possible to get a brace to support the leg while it scars down. Or do surgery. However, he's 13 and a lot of people don't want to put their older dogs through surgery and the required anesthesia.

    The knuckling of the hind legs definitely suggest spinal cord impingement of some kind. Often, with a full range of rehab treatment, including chiro, acupuncture, exercises, and underwater treadmill, the knuckling can be ameliorated. This would also mean that you have work to do at home – exercises from the DVD already mentioned.

    Heel, Inc., also has another injectable homeopathic called Discus compositum that my former boss used on dogs such as yours when she did aqua acupuncture.

    When on your walks, make sure that he is walking, not trotting. When he trots, he can shift his weight over his front legs and momentum keeps him going. To help strengthen the hind end, walk slowly enough that he is walking. Walk up hills, if possible, or across hills back and forth. Walk on uneven ground and over low sticks, etc.

  • Laurie Higgins

    I keep forgetting things.
    Subscribe to “The Whole Dog Journal” if you haven't already. And look into their archives. They are a rich source of information for lots of things – acupuncture, chiropractic, rehab, cancer, arthritis, pain management, etc.

    • Karlee

      Sorry Laurie! I read your post wrong, and I appologize.

      Sandy, It's great to hear that Cory doesn't have cancer *sigh*

      • Laurie Higgins

        Karlee, no problem. It can be confusing. Most dogs Cory's size would take probably a 0.8 ml. dose. The loading period is four weeks at 2x/week. That's about 6.4 ml. that first month, leaving 3.6 ml., or four more doses at 1x/mo. But he could also be up around 1.0 ml./dose. You just have to read the box and do some math converting lb./kg. to figure out what the dosage is. Fun.

  • Sandy DeMers

    Hey Laurie,
    Cory did have the MSI test that you described done by the neurologist yesterday. I have a call in to Cory's regular vet to see what her recommendations are once she gets the report from the neurologist. Cory does walk (not trot) and we spend most of the walk going up hills, so I'm very glad to know we are doing something right. I'm busy communicating with the lady that makes the Hartman harnesses to be sure I have taken Cory's measurements correctly. I hope to get it ordered sometime today. Again, thank you for generously sharing with us (and everyone else who is reading this) the benefit of your unique experiences.

    • Laurie Higgins

      You're welcome. And I can research the other harness if you're interested. I just have to contact someone to find out the name of it.

      • Sandy DeMers

        Nope, I already ordered one from Betsi Hartman, but thanks for the offer!

  • Cheryl

    I have a 16-year-old shepherd mix who is also having some arthritis/joint degeneration pain and stiffness. She was on Rimadyl for some time which did gave her relief but not a lot. I decided to take her off of it and try something else so for a couple months she's been on one daily glucosamine 750mg/chondroitin 600mg, one teaspoon liquid fish oil daily, and one baby aspirin in the a.m. and one in the p.m. When it is very cold (even though she is always in the house and has a nice mat, the floors are colder), I heat a bath towel or small blanket in the dryer and lay it over her – she really seems to like that. She is still stiff and I'm sure has pain, but she seems to walk better and feel better since taking her off the Rimadyl. I normally would not like to give a dog aspirin regularly, but she is 16 and I figure if it helps her at this point in her life, we're going to do it.

    • Cheryl,

      Thanks for sharing. Sandy has been draping a warm, wet towel over Cory's
      hind end whenever he lays down. We're not sure if it does him any good, but
      he doesn't seem to mind it in the least, so she keeps it up. Cory is also
      getting glucosamine and chondroitin daily, as well as fish oil.

      We feel the same as you… anything that we can do to help our dogs at this
      point in their lives, it's up to us to do it. We have to make them as happy
      and comfortable as possible. Right now we feel that our best option is to
      run a set of diagnostics on Cory's spine and then possibly proceed with
      surgery, as it appears likely that he has a herniated disc. We'll keep you
      updated right here! And of course, if we can find any magic remedies we'll
      be sure to share.

    • Sandy DeMers

      Thank you Cheryl. If your dog is 16 you have been doing lots of things right for her! Rimadyl did nothing for Cory, and now he is on Gabapentin, which is helping, and it is very safe for dogs as well, (Rimadyl comes with lots of warnings). You may want to look into it (call your vet), as it is better for them than aspirin. I like your idea about putting a blanket in the dryer to give a warm compress. I have been using a small towel in hot water (which I wring out) and put on Cory's back end. If he lays still it works, but if he wants to move around I have to run after him.

      • Haha, I can picture you running all around the house trying to put a wet
        towel over his butt 😉

        • Sandy DeMers

          No laughing at your mother Jayson!

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