Hi, I can help you with your question today.
I'm so sorry that you are in this position with Tia, it is so difficult when a beloved pet ages like this.
First, aside from the tramadol, have you ever used another pain medication like Rimadyl, Deramaxx or Metacam?
Do you know why the vet stopped this? Did she have problems with her liver or kidneys?
OK. Did the Metacam seem to help while she was on it?
Well, from what you are describing, I think it is very difficult to sort out if she is
having the problems with mobility and incontinence from a neurologic disease or if she is just having problems with her joints.
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.
It might be worthwhile to do a short trial with her on multiple pain medications.
We can use the Metacam with the tramadol for additive relief.
Metacam also is anti-inflammatory, which is helpful with joint disease/arthritis. Tramadol does not do that.
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.
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.
Is she on Previcox too?
Oh I see, I did not read that earlier.
Well, there are some additional things we could try such as amantadine or gabapentin.
I'm afraid we are getting to that point though, just as you feared.
Amantadine is something that can be prescribed to a human pharmacy, and it will take about a week before we would see results.
This medication helps to make the pain medications she is already on, particularly the tramadol, more effective.
The way that gabapentin works is not well understood, this one can also be prescribed to a human pharmacy.
It is relatively inexpensive.
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.
I hope so, I can't say for sure though. Both the amantadine and the gabapentin could help with this.
I do not know the cost for the amantadine.
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.
Since you said "chemist" I imagine you are in the UK?
I'm not entirely sure, as I'm in the US, but I do think both are prescription in the UK
Your regular vet should be able to call these in for you to pick up.
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.
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