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Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog
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Experience:  DVM, Emergency Veterinarian; BS (Physiology) Michigan State Univ
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I need someone to help me read my Dog, Bandits X-rays . Please

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I need someone to help me read my Dog, Bandit's X-rays . Please see my previous Dog Questions from before... Bandit has now has been off Tramadol and on acupuncture twice...they put him on a bunch of herbal meds and he had blackish diarrhea...we took him off all of that. No more diarrhea..they put him on Gabapentin for pain and Amoxicillian for the Diarrhea.

So I have a few questions.

#1- since he has no Diarrhea does he still need to be on Amoxicillian and is that a good med for diarrhea ?

#2- What do you think of Gabapentin?

#3- What do you see in the X-rays I will upload next.

P.S. - now Bandit is falling on his front legs...
Hello, I'm Dr Gary. I've been practicing veterinary medicine since 2007. I look forward to helping with your questions/ concerns.

Please do post the x-rays and I'll take a look at them for you.

1. I would go ahead and stop the Amoxi if the diarrhea has resolved.

2. I'm a big fan of Gabapentin for chronic pain and nerve pain in dogs. What dose are you giving him? What does he weigh?
Customer: replied 4 years ago.

Every time I try to upload a pic it is denied access

Customer: replied 4 years ago.

57 lbs 100 mg twice a day

Ok no problem.

Honestly, I don't even take x-rays in most disc dogs. The x-rays don't show the discs or spinal cord, so they're not all that helpful. Sometimes we'll see calcified discs or narrow disc spaces, but we don't see a ruptured disc or spinal cord compression. We need an MRI or CT to see those things. The point of doing these advanced imaging is to decide whether surgery is indicated or if we can treat with medical management. If I have a dog that has significant neurologic deficits and a compressed spinal cord, surgery is the way to go.

That Gabapentin dose is pretty low. I usually dose it at 10 mg/kg twice daily. In this dog, I would go with 200 mg twice daily or even 300 mg twice daily if that was not enough. I usually treat my disc dogs with an anti-inflammatory (Rimadyl typically, sometimes Pred) + Gabapentin +/- Tramadol +/- Methocarbamol/ Robaxin (muscle relaxer). I also make sure we're crating the dog and not allowing any running/ jumping or playing for a good 2-4 weeks.

If I'm a week or two in and I still can't get the pain controlled, I'll refer to a neurologist for an MRI and surgery. The main indications to go to surgery are: severe neurologic deficits (paralysis) or pain that cannot be controlled with medications.

I think acupuncture and therapeutic lasers are also good as adjunctive therapy. There's not a lot of research showing that they do a lot, but it doesn't hurt and some patients really do benefit.

If you're seeing falling the front legs as well, then we can assume the disc herniation is in the neck. These dogs are more likely to need more pain meds as they are more painful. I start most of my neck dogs on Rimadyl, Gabapentin and Tramadol right off the bat. If I can't get them comfortable, then they really should have surgery to remove the disc and decompress the spinal cord.

I hope this helps, and I'll keep an eye out for the x-rays.

Customer: replied 4 years ago.

Were you able to look at my previous questions?


he can't be on NSAIDs because his liver is a 1663...although went down to an 1100 (I gave him Milk Thistle...then stopped due to diarrhea and wasn't sure what's causing it, but I am assuming it's the other natural supplements the Accupuncurist gave him))


then the tramadol caused severe dysphoria...and major crying...which we though was pain but was really due to the Tramadol.



I can copy and paste my previosu conversations....or I think you have access to my previous questions from a few weeks ago right?


I am thinking of providing a link to dropbox for you to look at the Xrays



Customer: replied 4 years ago.
I looked at the other threads. I wouldn't be too worried about using Rimadyl. I'd just go with lower dosages than the typical labeled dose. I would go with 25 mg twice daily as opposed to 50 mg twice daily in a dog this size.

If you can't give Tramadol, then I would try Buprenex or even Amantadine. Amantadine is actually an anti-viral med that can be used for pain in dogs.

It's tough to manage these guys when they don't tolerate meds very well. He is a dog that I would say is a good candidate for surgery so that we can go in and fix the problem. It would be a faster return to normal and it will get rid of that painful compressive lesion.
Customer: replied 4 years ago.

were you able to look at the xrays?


the weird thing is, before we even took him to the vet 10 days ago, he was just stiff, not jumping on bed, etc. we walked him every day...


after the vet visit he is now in worse shape and his front legs are giving out...


I even asked my vet if they accidentally dropped him or he fell off the x-ray table...she said usually her vet techs would tell her if something like that happened.

Those x-rays look good. I'm not seeing any bony abnormalities. The L1-L2 segment looks a little narrow, but that's about it.

It is very common for dogs to first present with pain and then progress to neurologic signs after the visit. This is not because they suffer any trauma at the vet clinic, it's because the injury progresses. If you think about it, there is a disc herniation causing the reluctance to jump and pain. You go to the vet and get x-rays. Over the next couple days, the swelling around the spinal cord and nerve roots will progress. This makes them actually get worse the 2-3 days after they present. If the swelling is compressing the cord, then we also have neurologic deficits- falling, knuckling over, paralysis, ect.

Everything localizes to the neck at this point. I think that L1-L2 is either nothing or an old injury. If you can afford it, I would see a neurologist and get this resolved with an MRI and ventral slot surgery. They go in through the neck and decompress the spinal cord/ remove the disc material. I would expect a full return to function and resolution of the pain.
Customer: replied 4 years ago.

I am seeing an orthopedic specialist tomorrow morning. (Thank goodness I have vet insurance up to $7k per incident) They said something about an ultrasound...I need an MRI or CT scan?


It's interesting that you are seeing something at L1 or L2. They are telling me he has spondolosis so bad that one bone even formed a circle and that he looks like he was hit by a car because his rib cage didn't looks fractured in one spot and didn't form properly and I think #12 or 13 is where they said where disc damage may be.


We have had him since he was around 9 months old. Rescued him from the pound...something could have happened before then but I don't know.


A few years ago he had a stiff neck but after thinking about it, I attributed it to him trying to eat food off the stove and cranking his neck to grab it.





Customer: replied 4 years ago.

Also, I think Bandit was stiff for a while and we never noticed it that much. That's why it is weird that this seems "all of a sudden"


also on vet says rest 3-4 weeks, the other tells me "if you don't use it, you lose it" basically telling me to keep taking him on walks so he doesn't get more stiff.



I am pretty confused.


In addition, the orthopedic says it's important to tell them which vet is referring them. I am assuming they get commission. Which makes me very uncomfortable. I know the VCA vets work on straight commission.





Oh yeah he definitely has spondylosis, but that rarely causes an actual problem. That's not causing this type of pain or spinal cord compression.

I'm not sure what they're thinking with the ultrasound. This all sounds neurologic. I would skip the orthopedic specialist and make an appointment with a neurologist. That is where the problem is.

This is not something that happened when he was young. Everything points to a disc herniation in the neck that happened last week. These are common in dogs. They are also difficult to manage and many of them end up in surgery to resolve the pain and weakness.

I'm in the camp of crating these dogs with discs. Short leash walks (with a harness, not a collar) and crate confinement for 2-4 weeks.

I'm not sure how their pay works. I can't really comment on that.
Dr. Gary and 2 other Dog Specialists are ready to help you
Customer: replied 4 years ago.

Does gabapentin cause crying? I just gave him some and now he's crying

No, Gabapentin does not cause crying. That is more likely due to pain.
Customer: replied 4 years ago.

okay, thanks

No problem