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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 27443
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My 13 year old lab has been dragging his back

Customer Question

.My 13 year old lab has been dragging his back legs and having a tough time getting up and down. We've tried deramaxx and that doesn't seem to be helping anymore. Get visits are really expensive and they want to do more bloodwork and I can't afford that. What can I do to help him?
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 2 years ago.
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner. We use a multimodal approach to geriatric osteoarthritis in our dogs - dietary management, nonsteroidal antiinflammatory pain relief, neutraceuticals, life-style changes and stem cell therapy. When used concomitantly these approaches should synergize and provide the best control of symptoms. For example, Shasta might show considerable improvement if you add fish oil to his diet. The omega-3 fatty acids in fish oil are anti-inflammatory. I use the cost-effective generic human fish oils and dose them at 20 mg/lb daily of the EPA in the fish oil. You'll find the amount of EPA on the label of the fish oil product.
Avoid flax oil because it is poorly bioavailable to dogs. They can't metabolize it properly.
If you prefer, there are diets that are extremely high in omega-3 fatty acids. Hill's Prescription Diet j/d is one such diet.
Many vets feel that injections of Adequan (polysulfated glycosaminoglycan) work better than oral neutraceuticals such as glucosamine/chondroiton sulfate such as the over the counter Cosequin or prescription Dasequin (please see here: http://www.amazon.com/Nutramax-Cosequin-PLUS-Chewable-Tablets/dp/B003ULL1NQ/ref=sr_1_1?s=pet-supplies&ie=UTF8&qid=1432474254&sr=1-1&keywords=cosequin). Adequan is injected into Shasta weekly for a number of weeks at his vet's discretion. You can read more about Adequan here: http://www.adequancanine.us/ You can certainly see how one of the many generic over the counter glucosamine/chondroiton products affects Shasta. They aren't harmful but their efficacy is circumspect.
Regenerative stem cell therapy has come into its own and is now available for addressing osteoarthritis in dogs . Please see Vet-Stem's website here for more information:***@******.*** The regenerative stem cells are created from Shasta's fat cells and are capable of differentiating into a variety of tissue types including tendon, ligament, bone, cartilage, and muscle and have been proven to reduce pain and inflammation. I understand, however, that such an invasive and expensive procedure won't be appropriate at Shasta's age.
We have to suspect that just as in people, geriatric osteoarthritis in dogs is painful. If a prescription nonsteroidal antiinflammatory drug (NSAID) such as the Deramaxx isn't sufficient for controlling pain, please consider adding a well-tolerated narcotic such as tramadol to these therapies mentioned above. All of these drugs are available from Shasta's vet. Aspirin dosed at 10 mg/lb with food every 12 hours can be helpful in a pinch.
Weight reduction is essential. The less weight Shasta's joints need to carry, the better.
It's important to note, however, that Shasta's dragging of his back legs may indicate more than geriatric osteoarthritis. That's a symptom of myelopathy - spinal cord disorder - such as degenerative disk disease (a "slipped disk"), tumor in or around his spinal cord, or degenerative myelopathy - a Lou Gehrig-type of neurologic disease for which no treatment is available. Pragmatically speaking, if a drug such as Deramaxx isn't helpful, myelopathy is likely and barring surgery, Shasta won't be able to improve.
Please respond with further questions or concerns if you wish.
Customer: replied 2 years ago.
Thank you for your response. Those are a lots of options that you have given me however I think life is thank you for your response. Those are a lots of options that you have given me however I can't afford to go through most of the medical options you gave. We are ready feeding Hills science diet and giving omega-3's to him. Taking him on walks isn't an option right now because he can barely get up and he drags his back legs and the only way for him to lose weight would be to reduce his food and I already feel like his quality of life has significantly decreased and I just want to make him happy and as comfortableas I can as I know he's not going to be around much longer. You mentioned a couple of medications I could do for him, aspirin being one of them and Tramadol bring another. i have aspirin and will give him that, but you said in a pinch so how often can I give this to him? And Tramadol is this something I can get over the counter? And how much would I give him? Thank you! Shelby
Expert:  Dr. Michael Salkin replied 2 years ago.
I understand, Shelby. You're necessarily limited to how much you can do for Shasta at this time. As mentioned above, aspirin can be administered at 10 mg/lb with food every 12 hours - indefinitely if need be. Watch out for GI upset, however. If you notice drooling or vomiting, aspirin should be discontinued. Tramadol is a prescription narcotic and not available over the counter. It would need to be prescribed by Shasta's vet.
Please continue our conversation if you wish.
Customer: replied 2 years ago.
Which medication is safest?
Expert:  Dr. Michael Salkin replied 2 years ago.
The medications all have their benefits and risks. Nonsteroidal antiinflammatory drugs such as Deramaxx and aspirin are analgesic by nature of their antiinflammatory action. They might cause gastrointestinal distress, however. Tramadol is a safe narcotic but it's not antiinflammatory and can potentially cause a variety of adverse effects including excessive sedation, agitation, anxiety, tremor, dizziness, inappetence, vomiting, constipation or, conversely, diarrhea.
it's not unusual to administer a nonsteroidal antiinflammatory drug concomitantly with tramadol.
Customer: replied 2 years ago.
So you're recommending I would do Deramaxx and tramadol together but not Deramaxx and aspirin? But in order to do tramadol I have to take him into my vets office to get a prescription for that? That's not something you can prescribe?
Expert:  Dr. Michael Salkin replied 2 years ago.
If you didn't see a response to Deramaxx, it's unlikely that you would see a response to Deramaxx plus tramadol. You'd have better pain control when the two of those drugs are given together but Shasta may not be painful. Instead, he may be numb in his hind end and there isn't much we can do for those dogs.
No, you mustn't administer Deramaxx along with aspirin. They're both nonsteroidal antiinflammatory drugs and two of that kind of drug at the same time can cause gastrointestinal ulceration.
No, I regret that I'm not allowed to prescribe through this venue.
Customer: replied 2 years ago.
Ok. Thank you. Is there a place I can go to get a prescription without having to pay a vet bill again?
Expert:  Dr. Michael Salkin replied 2 years ago.
Possibly, yes. Your vet could write or call in a prescription to Costco, for example, who now carries quite a few drugs for dogs. It's worth a call to the vet to see if he/she is amenable to doing that for you.

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