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Dr. Susan
Dr. Susan, Veterinarian
Category: Dog
Satisfied Customers: 6785
Experience:  8 years of clinical experience with specialty in veterinary pain management, urology, and geriatrics
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My Labrador is 14 years and 6 months old. Her back legs are

Resolved Question:

My Labrador is 14 years and 6 months old. Her back legs are very weak and vet has said there is muscle wastage due to her age. She struggles to walk on kitchen tiled floor as keeps slipping over and we have to put her back too her feet most times howerver when she is focused too getting a chew or her dinner she is more steady on the floor. She has good and bad days with the back step to the garden. She still seems to enjoy her walks but seems to loose her footing and has to be put back on her feet now and then. She is incontinent (more so with her bowels) and we come down most days to mess, she even messes in her sleep after a walk or in the car after a walk. She rarely wags her tail. She has started to pace around for hours in the evening, but since vet has increased tablets for lameness (tramadol) she is far more sleepy in the evenings. I'm considering the time has come to say goodbye but I need to sure I'm doing the right thing. Can you give me your thoughts and advise?
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Susan replied 2 years ago.

Dr. Susan :

Hi, I can help you with your question today.

Dr. Susan :

I'm so sorry that you are in this position with Tia, it is so difficult when a beloved pet ages like this.

Dr. Susan :

First, aside from the tramadol, have you ever used another pain medication like Rimadyl, Deramaxx or Metacam?

Customer: She was on meta am before.
Dr. Susan :

Do you know why the vet stopped this? Did she have problems with her liver or kidneys?

Customer: She was weeing a lot but they checked out her kidneys and all was fine. Don't remember why they took her off it. Were worried about cushings but she was tested for this and was negative
Dr. Susan :

OK. Did the Metacam seem to help while she was on it?

Customer: For while but then she became very I'll with abses on her face and that became a priority to sort out. Think she was put on steroids and taken off the metacam
Dr. Susan :

I see.

Dr. Susan :

Well, from what you are describing, I think it is very difficult to sort out if she is

Dr. Susan :

having the problems with mobility and incontinence from a neurologic disease or if she is just having problems with her joints.

Dr. Susan :

Some of my painful patients will have accidents because they don't want to walk to the door to go out, and it is painful for them to posture to urinate and defecate.

Dr. Susan :

It might be worthwhile to do a short trial with her on multiple pain medications.

Dr. Susan :

We can use the Metacam with the tramadol for additive relief.

Dr. Susan :

Metacam also is anti-inflammatory, which is helpful with joint disease/arthritis. Tramadol does not do that.

Customer: so would you say the Metacam is better than prevocox?
Dr. Susan :

I do agree though, that her current quality of life sounds decreased. She sounds uncomfortable. Housetrained animals also feel emotional strain from having accidents in the house or car. They know that it is "bad", and feel upset when this happens.

Dr. Susan :

Previcox is a drug in the same class, so technically they should be about the same. Just as with people though, one drug might be better than another - some people prefer Aleve to Advil for example.

Dr. Susan :

Is she on Previcox too?

Customer: I totally understand, she does not get told off now if accidents happen, I can see from her body language she is upset by the mishap.
Dr. Susan :

Exactly.

Customer: She is on previcox too yes
Dr. Susan :

Oh I see, I did not read that earlier.

Customer: That's ok
Dr. Susan :

Well, there are some additional things we could try such as amantadine or gabapentin.

Dr. Susan :

I'm afraid we are getting to that point though, just as you feared.

Dr. Susan :

Amantadine is something that can be prescribed to a human pharmacy, and it will take about a week before we would see results.

Dr. Susan :

This medication helps to make the pain medications she is already on, particularly the tramadol, more effective.

Customer: What is this drug for
Dr. Susan :

The way that gabapentin works is not well understood, this one can also be prescribed to a human pharmacy.

Customer: Sorry just seen your answer
Dr. Susan :

It is relatively inexpensive.

Dr. Susan :

At first, the gabapentin may make her sleepy, but that is usually a transient side effect and will go away after the first week or two.

Customer: So this will help with her lameness?
Dr. Susan :

I hope so, I can't say for sure though. Both the amantadine and the gabapentin could help with this.

Customer: I guess there is nothing to. Be done for incontinence?
Dr. Susan :

I do not know the cost for the amantadine.

Customer: So I can get over counter at chemist rather than from vet?
Dr. Susan :

My hope is that she isn't truly incontinent. As I mentioned earlier, I have patients that will urinate and defecate in the house because they have so much trouble with their mobility. Then, once we improve their mobility and comfort, the incontinence resolves.

Dr. Susan :

Since you said "chemist" I imagine you are in the UK?

Customer: Yes
Dr. Susan :

I'm not entirely sure, as I'm in the US, but I do think both are prescription in the UK

Dr. Susan :

Your regular vet should be able to call these in for you to pick up.

Customer: So I should concentrate on improving her mobility and in turn hopefully less accidents. To be fair I'm kind of preparing myself for her final months. Itjust worries me she is in pain and I reallly don't want her to be suffering
Dr. Susan :

The only other thing I can think of is a lidocaine patch. These are also prescription in the US. These are local anesthetic patches and can be used directly over her joints (I would try these on her hips). These are TOXIC if ingested though, and she absolutely MUST wear an elizabethan collar if we tried this.

Customer: OK thanks for your help. I've got go out now you have been most helpful.
Dr. Susan :

You're welcome! 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.


Please remember to only rate my answer when you are 100% satisfied. I will be happy to continue further and do everything I can to provide you with the service you seek.

Dr. Susan, Veterinarian
Category: Dog
Satisfied Customers: 6785
Experience: 8 years of clinical experience with specialty in veterinary pain management, urology, and geriatrics
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