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Dr. Altman
Dr. Altman, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 12456
Experience:  Practicing small animal veterinarian for 17 years.
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My 7 year old german Shepard/Rotweiller mix has been

Customer Question

My 7 year old german Shepard/Rotweiller mix has been diagnosis with Dynamic Degerative Lumbo Sacaral stenosis. Before he wa 1 1/2 years old he had both hips replaces due to the onset of arthritis. Thre replacements are hodomg up well. The VCA hospital we are using has a review rating of a 3 and the surgery cost is between $6000 - $8200. i have already spent over $2000 in tests and mris. i am looking for a well rated vet for a second opinion to see if there is another other option that surgery and at a lower cost.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Altman replied 1 year ago.

Welcome to Justanswer! I am Dr. Altman and happy to assist you both today!

I am so sorry to hear Mac has already been through so much in his life. Can you please tell me what clinical signs he is showing at this point with his LS disease? Also what was found on the MRI and how severe his compression is? It gives me a starting point to determine how severe his symptoms are and if other options such as medical management are viable for him

Thank you

Expert:  Dr. Altman replied 1 year ago.

While I am waiting for your response I will review medical management options for you. I have a German Shepherd who was diagnosed at the age of 2 and is now 8 years old. I have managed her with the protocol below and she is comfortable and active but I am very aggressive about her care and prevention of pain...

There are so many options available to us now to help our beloved four-legged friends outside of the normal nonsteroidals (rimadyl, previcox, metacam, deramaxx). I will list them individually but all can be used in combination to assist your dog in getting comfortable

1.) Gabapentin- this is called neurontin in people. It works by dulling the nerve firing associated with pain and is my top choice for senior pets because it is not metabolized as readily by the liver and is easier on a senior pet. The pros are that it is not pricey, has no high end dose so if the pain escalates as your pet gets older we simply adjust the dose, and is easier on older pets. The cons is that it has to be given consistently because withdrawing it suddenly causes what is called rebound of pain which is higher then original level, can cause mild sedation initially. My dog started at 100 mg every 12 hours and is now up to 300 mg every 12 hours

2.) Tramadol- this is in the opioid class so it is given as needed for pain when there are bad days. It can be given longterm to senior pets two to three times daily if needed. I do this with my dog along with rimadyl when she has a more active day such as yesterday when we went to the lake and she ran around and was very sore last night

3.) Alternative medicine: laser or light therapy, acupuncture, physical therapy, massage therapy. All are fantastic ways to help minimize pain, increase strength, and allow rest more comfortably. If there is a physical therapy facility in your area they would have all of these. Typically I will start with acupuncture and/ or laser therapy and then add in the physical therapy once we are more comfortable to build strength. I often see remarkable results with one to two sessions. I also do this with my dog and truly believe this has been her saving grace. She gets laser therapy at least once to twice weekly and physical therapy every 2-4 weeks based on her comfort. It is critical to manage her pain because I have an outside person palpating her regularly and assessing her comfort level

4.) Adequan injections. These are pricey but given twice weekly subcutaneously (I have owners give the medication at home after a demonstration to minimize the visits) for four weeks then taper frequency as improvement is seen and if there are bad periods then increase frequency once again

5.) Supplements: Glucosamine sulfate 1500 mg daily, fish oil with 1500 mg EPA & DHA daily, Vitamin E, Ester C are all great to slow progression of disease and assist in comfort

6.) Depending on your pet's size, a help em up harness that is used to support standing and moving to minimize injury to your back but also prevent further injury to you pet.

I hope this information is helpful in getting Mac comfortable and avoiding surgery. If you have more questions or if I can help in any other way, please do not hesitate to ask! If you would like to accept my answer, please press RATE OUR CONVERSATION. Bonuses are always welcome (I am not compensated in any other way). Thanks!