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petdrz, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 7385
Experience:  Over 30 years of experience caring for dogs and cats
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I have a 15 year-old big dog, form whom $250 of meds

Customer Question

I have a 15 year-old big dog, form whom $250 of meds (tramadol, rimadyl, and gabapentin) are not helping. She won't lay down, walks around panting and whining, all day, all night. I'm at my wit's end because the vets keep trying to weak her meds, and run expensive tests, and nothing is working. I think she's miserable, and I don't know how to make her comfortable.
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  petdrz replied 2 years ago.

I am sorry that you have been waiting for a response. I recently just logged onto the site and noted that your question hasn't yet been answered. I am a licensed veterinarian with over 25 years’ experience and would be happy to work with you if you are still needing assistance.

Does her behavior seem to be due to pain or is it possible that she is restless for other reasons?

Has she had xrays of her hips and spine taken? If so, are there visible abnormalities?

Does she sleep at night?

Thanks and I will respond further after you reply. There may be a slight delay while I formulate and type a thorough response or I may be offline, but if so, I will respond as soon as I am able.

Customer: replied 2 years ago.
She has had xrays-- very apparent arthritis, and now she sometimes falls down, and can't always get up. It really seems to be pain to me. Or maybe some senility. And no, she rarely sleeps at night.
Customer: replied 2 years ago.
They're now trying to figure out why she is incontinent, and want to run a whole bunch of tests, because the urinalysis was negative. I'm frustratee because i've spent literally thousands of dollars over the past 4 months, and nothing changed-- she is still restless, pants really heavily all day, falls down, is incontinent. And the thought that she may really be suffering kills me.
Customer: replied 2 years ago.
She was such a majestic, strong, proud dog for years (I've had her since she was 4 months old), and seeing her like this is the hardest thing.
Expert:  petdrz replied 2 years ago.

Thank you for the reply.

I know it can be very difficult to watch our pets age, especially when you feel they may be suffering and you are not able to provide relief.

It can be a challenge to differentiate her symptoms as due to pain or other possible causes. Degenerative diseases such as degenerative myelopathy (link here) can be debilitating and progressive and do not usually respond to pain medications. Fortunately, they do not usually cause pain though, but only loss of function. Other conditions that cal lead to the restlessness and the panting can be behavioral in nature.

I would wonder if maybe she were starting to show signs of a condition called cognitive dysfunction. It is a condition that we see in older dogs with signs that vary from dog to dog. For lack of a better comparison, it is similar to Alzheimer's disease in humans. Here are a few links with more information:

cognitive dysfunction

CDS in dogs

Here are some of the most common signs seen, but there are others as well including restlessness and panting:

general confusion - your pet doesn't greet or seem to recognize you as before, your pet gets 'lost' in the yard or house

inappropriate vocalization - barking or meowing in the middle of the night, or for no 'good' reason? (I know, some dogs don't need a reason to bark.)

getting day and night mixed up - sleeping all day, awake all night?

confusing indoor and outdoor - a previously housebroken pet soiling in the house?

personality changes - i.e. a formerly outgoing pet becoming timid or aggressive?

I have seen a good number of dogs affected by this and all have exhibited different signs, especially in the early stages. I would have your veterinarian perform a thorough physical exam to make sure there is nothing else going on.

Some dogs I have seen have responded to diet change alone. Hill's b/d diet is a good choice. LINK HERE If not, the medication called Anipryl® is very effective for many dogs.

I generally start with supplementation first (+/- diet change to b/d if there are no other dietary restrictions needed). I usually recommend increasing the omega 3's in the diet as well. The active ingredient of fish oil is EPA (Eicosapentaenoic Acid) and DHA (Docosahexaenoic Acid). You just want to make sure you are seeing those on the label as an ingredient and not just the words "fish oil" as these are the important part of the fish oil and not all fish oil capsules have them in it, especially the cheaper ones. Aim for 180mg EPA and 120 mg DHA per 10 lbs body weight daily. There is a large range of safety and it doesn't have to be that amount exactly but this gives you some guidelines.

There are various additional supplements on the market to help with brain health. The three most readily available are: Cholidin, Senilife and Novifit. As far as which supplement to try first, I do not think there is any general agreement on that. Between the cholidin, senilife, and novifit I would make my decisions on which to use based on cost, ease of administration and availability. I do not see a problem with using them all if cost is not an issue and you have a dog who doesn't mind taking oral supplements. There may be more benefit to starting with multiple approaches for a greater combined effect and backing off to a minimum effective combination if you get a favorable response. It is not always easy to track response as the symptoms can be variable and intermittent.

I would add the Anipryl if needed for better effect or as the cognitive dysfunction progresses.

Urinary incontinence is not uncommon in older female dogs due to weakening of the urethral muscles and leakage of urine. The drug called phenylpropanolamine can be very helpful if this is occurring and if she has not tried that, may be worth mentioning to your vet.

Maybe adding some of these other medications or supplements will help. It is difficult as her symptoms are likely not due to just one thing, but more likely a combination of conditions.

I hope this is helpful. Please let me know if you have ANY other questions. My goal is to give you 100% satisfaction and if you are not yet satisfied, please reply so I can clarify for you.

Dr Z