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Welcome! I am Dr. Altman, a licensed veterinarian and happy to answer your questions today.
It sounds like Sophie has had quite a history!
Although rimadyl is not on the list of medications that have been documented as causing problems with dogs with this mutation we can never rule this out
Has she had recent bloodwork to ensure her liver values are alright?
And a thyroid panel has not yet been done? Have you investigated the use of gabapentin to minimize the need for rimadyl? It is not on the list either.
Collies definitely do have a predisposition for hypothyroidism
Was it just a thyroid level (t4) or a thyroid panel (t4, free t4, tsh)?
If she was borderline then than there is a higher likelihood now
It can exacerbate the muscle loss and neurologic signs unfortunately in some cases
I have had a few cases that went against the grain as Sophie does. I try not to put everyone in a box and have found that some cases vary. It sounds like Sophie is in a class of her own and might be one of those cases.
I had a hypothyroid case that was losing weight and having neurologic signs...with treatment the weight maintained and some of the muscle loss leveled out
Yes I would
No harm in checking it
Do you know if her cholesterol level is normal?
OK, an elevated cholesterol commonly goes along with hypothyroidism but a normal cholesterol does not rule it out
Have your vet discussed gabapentin for her to reduce the need for the rimadyl?
Gabapentin (aka neurontin in people) is a medication that is used to dull the nerve firing associated with pain
It is my first line of defense for pain management in senior pets and using rimadyl/ nsaids sparingly as a result
Until end stage arthritis/ pain management is needed
I am definitely a minimalist when it comes to medications and use the safest/ least invasive first and foremost
Benefits: cost, easier on liver/ kidney function, safer for senior pets
Negatives: sedation initially while they get adjusted to the medication which they do get accustomed to and wears off, they have to stay on it consistently and then weaned if removed
Since it dulls the nerve firing associated with pain if they are removed too quickly they can have what is called rebound effect
I usually start on a lower dose and that way as pain escalates as they age I can increase the dose
That is a great question and every case if different
If I have a dog with a really low/ unreadable number with no clinical signs the owner and I will discuss whether a dog is clinical
If they are not I still will not treat unless they do become clinical
Meaning: weight gain/ loss, muscle loss, lethargy, thinning coat, increased panting
I would do a thyroid panel and rule that out which can take 3-5 business days and in the meanwhile research the gabapentin and discuss with your vet so you feel comfortable trying this if the thyroid panel is normal
Or, let's say the thyroid panel is not normal, it doesn't mean you cannot do both
But I understand wanting to try one thing at a time as well
I just really prefer not to use the nsaids unless I have to. Using it on bad days as a "rescue" medication and safer meds more consistently until you don't have a choice
I think likely you have two different issues going on
Have you tried her on antacids to see if that helps? Is there one meal during the day that she consistently does not eat as much versus the other (breakfast versus dinner)?
Reduced appetite can also be due to pain as well
The rimadyl can definitely be causing stomach ulcerations/ reduced appetite
Were you still giving rimadyl during those days?
Hmm, it really makes me wonder if it is related
It might be worthwhile until you speak to your vet adding in an antacid prior to the rimadyl
How much does Sophie weigh?
Do you do rimadyl once or twice daily?
I would try famotidine (pepcid) 10 mg every 12 hours about 15 minutes prior to the rimadyl
I have had cases where this is the case. Rimadyl can be quite hard on the intestinal tract
Yes, definitely. I would love to find out how things go. Set a reminder for perhaps 10 days to see if you have additional information? I can do this after you have rated our chat, there is no additional charge
I will set the reminder and you will receive an e-mail at that time to bring you back into the chat
You are welcome
Can I assist with any additional questions this evening?