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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 14826
Experience:  Over 20 years of experience as a veterinarian.
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An 11 year old German Shepard with diagnosed p dysplasia is

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An 11 year old German Shepard with diagnosed hip dysplasia is now having real problems getting up and walking. His rear ended appears very unstable with one leg less functional than the other. Would any of your suggested remedies, e.g. Cosequin be truly helpful?
Submitted: 5 months ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 5 months ago.

Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that your fellow Magic has previously been diagnosed with hip dysplasia and is now unable to use his rear legs properly, with one leg less functional than the other.

I understand that he is already taking Carprofen 100mgs twice daily and glucosamine with MSM 1500mgs once daily.

Cosequin is a glucosamine/chondroitin product so it may or may not be more helpful than what you are already giving if your product does not contain chondroitins. And some glucosamine/chondroitin products are better than others. That's because the FDA does NOT regulate supplements. As a result some disreputable companies put out products that contain little to none of the ingredients listed on the label, so I always recommend sticking with a reputable company like Nutramax.

My concern for him is that while hip dysplasia causes pain, and thus often leads to stiffness and a reluctance to rise, it should not cause weakness or instability in his rear end. He may have something else going on.

Has he ever had radiographs of his spine or hips?

If you pinch his toes on his rear feet does he feel it?
If you support him standing and flip his rear feet so the topside is down does he immediately right them?

It is important to find out whether he is too painful to get up and move properly or whether he has lost the ability to do so due to loss of neurologic function. That would be a whole different issue.

Is he able to hold his eliminations and go consciously or has he has lost the ability to control his urine and stool (incontinence)? If he has loss of control then that would be an additional sign that he has loss of neurologic function.

If he is painful, but not truly weak is very possible that he is showing signs of worsening dysplasia. Sometimes it is simply too painful to get up and move. Symptoms can worsen suddenly if a piece of the arthritic changes in his hip breaks off and is free in the joint.

But if he is dragging her toes that can signify neurologic problems, such as an intervertebral disc(s) (cushions between the bony vertebrae) that are out of place or spinal arthritis putting pressure on the spinal cord or even a mass in or around the spinal cord.

Another possibility is a condition called FCE, fibrocatilagenous emboli, where a chunk of cartilage breaks off and lodges in the blood vessels that supply the spinal nerve roots. It is very painful initially as blood supply to tissue is blocked off. The pain only lasts a short time, less than a few hours to a day, but the weakness from the nerve damage it causes it can last for weeks or in rare cases is permanent.

Rotties and German Shepherds are prone to a disease process that affects the rear legs called lumbosacral stenosis (LSS).
It can have many of the same symptoms as a FCE as it causes neurologic symptoms too (weakness and incoordination). It is caused by weak spinal ligaments that allow the bones in the spinal column to move and place pressure on the spinal cord or it can be due to inflammation of the ligaments inside the spinal cord canal causing pressure on the spinal cord leading to loss of function, just like a FCE.

FCE are initially painful but after that it's just a matter of regaining function.
LSS can be painful on and off until the spinal column is stabilized and the pressure is taken off the spinal cord permanently.

Another possibility if he seems uncoordinated but not painful is a condition called ascending myelopathy. This is a progressive degeneration of the spinal nerves that begins with incoordination of the rear legs then progresses to loss of urine and stool control (continence).

He really needs a veterinary examination as soon as possible. Radiographs to look for a collapsed disc space or arthritis of the spine and hip dysplasia would be helpful. We need to know what the problem is to treat it successfully.

If those look fine then an MRI of his spinal cord in the back of the body is an option that would be helpful in achieving a diagnosis.

Pain and inflammation in these conditions is controlled with nonsteroidal anti-inflammatories like Carprofen, Metacam, Deramaxx or Rimadyl as well as Tramadol and/or Gabapentin for pain.
You can use these with the omega 3's and glucosamines if arthritis or hip dysplasia is diagnosed. These nutraceuticals help improve cartilage and joint fluid health as well as reduce inflammation.

I recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). I recommend an omega 3 fatty acid dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give him 20mg of EPA per pound of body weight per day. For example an 80 pound dog could take 1600mg of EPA per day. Omega 3's and glucosamine/chondroitins work synergistically and improve cartilage health and joint fluid quality and quantity as well as reducing inflammation. They can take several weeks to see full improvement but some dogs do very well with them alone. They are available over the counter.

Another option is a product called Duralactin. This is an anti-inflammatory product derived from milk proteins and it also has omega 3 fatty acids incorporated into it which can be very helpful. See this link for further information: http://www.duralactin.com/products_canine.htm

There is no treatment for myelopathy, unfortunately. We can only definitively diagnose that condition after death because it requires a biopsy of spinal cord tissue. We usually rule out everything else and with a history of little to no pain and a gradual onset then we assume it is myelopathy. There is a blood test that looks for genetic markers for the disease and if he shows symptoms and is positive for the markers it is fairly certain he has it. But there are some dogs that have myelopathy and test negative for the markers. Those are less common cases, but can only be diagnosed after they pass a way. If you want to test him for the disease here is a link to a website which will give you information about how to get him tested:http://www.offa.org/dnatesting/dm.html

An MRI of his spinal cord will help diagnose intervertebral disc disease or lumbosacral stenosis. Those conditions can be treated surgically.

In the meantime try and keep your pup quiet. With spinal instability the more they do, especially jarring activities like running and stairs, the faster the condition can progress.

And you can certainly try Cosequin in addition to Carprofen, with the warning that if this is related to loss of nerve function it may not help.

Please let me know if you have any further questions.

Expert:  Dr. Kara replied 4 months ago.

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things are going for your fellow. If you could give me an update that would be great, thank you, ***** *****