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Hi, i`m Richard, a Veterinarian from the UK. Hopefully I can help today.
Has he been drinking more recently?
Any sign of weight loss?
What prompted your vet to test for Cushings? Was it due to the panting?
The panting could also be due to pain. Is he on any medication for his sore back?
What dose of tramadol do you give him?
Do you have an idea of Jake`s weight?
Ok, to start with, that is a fairly low dose of tramadol (if he weighs 37-40lbs). He could tolerate a dose of 50mg without issue and this will likely have a better pain killing effect. If his deramaxx is wearing off overnight and he is on such a low dose of tramadol, he may be uncomfortable overnight, leading to the panting. Have you tried a higher dose of tramadol so far?
Initially it may be worth giving a higher dose of the tramadol, to see if that helps. Does he seem more comfortable during the day?
The peeing in the house could simply be a stress response, so yes, it could be attributable to pain. It may be worth having your vet check out a urine sample however, to rule out diabetes or kidney issues.
Ok, has he had blood work other than the cushings test?
In that case if diabetes and kidney disease has been ruled out, I would be keen to try the increased tramadol dose to see if that yields an improvement. You could also try and give the deramaxx in the evening instead of the morning, to see if things are any better with a change of regime.
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You can give the tramadol with the deramaxx if you intend to give them both in the evening, however initially, I would stick to your normal routine but increase his tramadol dose to 50mg instead of 25mg. Hopefully this is clearer.