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Dr. Barbara
Dr. Barbara, Dog Veterinarian
Category: Dog
Satisfied Customers: 1614
Experience:  Over 30 years experience in veterinary medicine and surgery.
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, My dog a 11yr old cocker spaniel (blue roan) went for

Customer Question

Hi,
My dog a 11yr old cocker spaniel (blue roan) went for an operation a couple of months back to remove a few lumps within her body, notably one on her rear right leg next to her tail (was causing her problems, but was not cancerous), however they seem to have botched it as a few days later she had to go back into surgery and came out with a tube in her leg (where the lump was removed) as she had developed a haemorrhage and this tube was supposed to drain the excess fluid/blood, this was kept as an open wound throughout. In the flowing days she was in and out of the vets to check on her progress but something didn't seem right and one night we decided to take her to the emergency vet who then made the decision to staple a morphine patch to her to help with the pain she was in.
Throughout this she was still walking here and there but with trouble which we put down to recovering from the operation, however once she had healed we noticed that she was still having trouble walking and her tail would no longer wag (which its used to do almost 24/7). It got to the point that she would cry when standing up and was wobbly on her feet, she went back to the vet who then diagnosed her with arthritis (which we've always known that she has had slight arthritis as that's a given with old age) and prescribed Tramadol. After a week of no progression we decided to get a second opinion, this vet (without scans etc) came to conclusion that the operation at some stage had caused nerve damage which lead to muscle wastage, so prescribed Metacam (10ml - 15ml per day) and Gabapentin (3 tablets per day), then said keep en eye on her for a week.
Which leads me to present day (after that long winded description of what has happened) my question is what to do going forward? Is there anything I can do as the vet was quite brief? She is still able to more or less get about, some days are worse than others where you have to prop her up and hold her up, good days where she walks/wobbles about by herself then has to have a rest. I am increasing her protein intake and stretching/massaging her legs twice a day but the weird thing is she still can't wag her tail, or well barely (only when she is extremely excited), she lets me touch any part of her back and leg but if I was to touch her foot or slightly higher she starts to cry and pulls away???? Is there a reason for this?
Both vets have said she is extremely healthy for her age and is still eating well so I refuse to believe that this is down to old age as it has happened to close to the operation but is it reversible? I guess without further scans its hard to tell which insurance wont pay for and we cant afford, but I hate the idea of me doing something could make it worse. I do understand that there is a possibility of euthanasia but I want to make sure that I have tried everything possible before it even comes close to that.
If you need any further information please let me know.
Thanks
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Barbara replied 1 year ago.
Hi,
Welcome to JustAnswer. I'm a licensed veterinarian and I'll be happy to help. I'm so sorry to hear about your little girl's dilemma! Very glad to hear that she is eating normally. I do need some more information to hopefully give you some productive guidance. Have all of her wounds (surgery sites) completely healed? Do any of the sites seem very tight. . .stretched skin that is impairing her movement?
Honestly, I am not surprised that the Tramadol had no effect. . .it takes about 14 days of appropriate level of medication before it has any effect!
The Metacam and Gabapentin should be more effective. How much does your little girl weigh, what is the concentration of the Metacam your are giving (how many mgs per ml), and what is the size of the Gabapentin pills you are giving. . .how many mgs per pill. I'd like to check her medications. For how long has she been on these medications? Does she still have opiate pain relief through pills or a patch?
Let's start here. . .
Dr. Barbara
Customer: replied 1 year ago.

Hi Dr. Barbara

Thanks for your reply, yes her wounds have fully healed and there doesn't appear to be any tightness in her skin. Both legs are affected by this, really each one as bad as the other. On a bad day she can barely stand, on a good day she walks a short distance with wobbly legs that I can only relate to models when they walk down the cat walk.

I believe she weights approx. 12kg/26lbs

Metacam = 1.5mg/ml administered once a day in the morning given 10-15ml

Gabapentin = 100mg per pill and given 3 times a day, however vet stated it can be reduced to 2 a day.

Metacam she has been on for around 3 weeks, Gabapentin only for three days.

These two are the only medications that she is taking and the morphine patch came off probably a month ago now

Thanks

Expert:  Dr. Barbara replied 1 year ago.
Thank you for your answers!
On the light side. . .what a great description of her tottering walk!
Has your vet thoroughly checked her joints (hips, knees, and ankles) for any pain when they are manipulated or swelling? Has your vet checked her anal tone? Has he/she checked her for normal placing of the feet (called conscious proprioception)? Has he checked her lower back by deep palpation to determine if her back is painful? Has she had back and rear leg x rays?
I've checked her dosages, and her dose would be 1.2mg of the Metacam once daily. The concentration of the oral liquid is 1.5mg/ml so she should be getting 0.8ml once daily!!!!
The Gabapentin dose is 10-30mg/kg every 8 hours. She is a little low on this medication. She should be getting 120mg at the minimum so you could give her 1 1/4 tablet 3 times daily.
Customer: replied 1 year ago.

I don't believe the vet has, I wasn't in the room when she was being assessed, but I will call the vet and ask tomorrow. No scans have been done either. I do however try each day to massage and stretch her legs just to keep them moving.

Apologies I think I got that wrong when looking at the syringe, she has between 1.0 and 1.5ml of metacam per day not 10-15ml.

Thanks

Expert:  Dr. Barbara replied 1 year ago.
Oh phew!!!!!
Do you think that she is stumbling (or tottering) with her front legs also? Does she seem to be normal mentally. . .not disorientation?
Customer: replied 1 year ago.

No her front legs seem stable, if anything that is what she uses to keeps herself upright. Apart from whining every so often (she has always been a bit whiny) due to wanting someone to be with her and wanting food she is in great health, no not disorientated, you can tell sometimes she is fed up as we have a 1yr old dog who runs everywhere who she can no longer run with.

Expert:  Dr. Barbara replied 1 year ago.
We have to find out if her problem is spinal (neurological) or is it solely due to osteoarthritis.
If it is all arthritis, then we should be addressing that more aggressively (ie add omega 3 fatty acids, and start glucosamine chondroitin. There is also intra-articular stem cell therapy that can help and Adequan injections). All of these are aimed at slowing the progression of the articular inflammation and producing the healthiest joints possible.
However, it really sounds to me like something has affected her lumbar spine, and this is not a normal result of surgery or healing. What leads me to think this is that she is paretic (not paralyzed but does have some loss of function) in her tail and her rear legs. She can also lose the function to defecate and urinate normally with this, but you haven't mentioned any problems here. . .am I correct?
The most common cause of this is a herniated (or slipped) disc. This is very painful at first and causes loss of the function you are noticing in her tail and her rear legs. This can lead to total paralysis if not treated medically or with surgery.
Medical treatment is with the meds you are giving for pain but also protecting her back to allow it to heal. This means keeping her back in a horizontal position and giving her cage rest (or the equivalent) for 6-8 weeks. She should definitely not go up and down stairs, should not jump onto any furniture, and when you hold her keep her back parallel to the floor by supporting her rear and front ends at equal height.
She needs an MRI to diagnose this. MRI machines are not in general practices, but located in specialty practices and at veterinary colleges. The ER vet you saw may be in one of these large specialty practices.
Does all this sound like a good possibility to you?
Dr. Barbara, Dog Veterinarian
Category: Dog
Satisfied Customers: 1614
Experience: Over 30 years experience in veterinary medicine and surgery.
Dr. Barbara and 4 other Dog Specialists are ready to help you
Customer: replied 1 year ago.

Many thanks for your feedback - sorry for not replying sooner.

Our parents are in the mindset of putting her down as they seem to believe that her issues are non treatable, however, my sister and I strongly feel that an X-ray will provide a clearer picture of what is going on: if it is purely arthritis then we know (as per your advice), there are measures in place to help alleviate the issue.

She has not lost the function to go to the toilet, although as I have said, getting her outside involves being lifted sometimes. As her tail is 'out of practice', she urinates on it and we need to clean it to avoid her turning yellow!

In your expert opinion, do you feel that we should pursue with the X-ray? Would an X-ray show the position of the spine and the slipped disc?

We really appreciate your support on this.

If you are able to get back to us as soon as possible this would be great as we really want to discuss all of the options with our parents before they make their final decision.

Expert:  Dr. Barbara replied 1 year ago.
Hi James,
Two pieces of information that should help you. I definitely recommend xrays to hopefully find the problem. If this is suddenly a worsening of existing arthritis, then with proper medication and time to heal, the arthritic joints should return to the level of function she had. If it turns out to be her spine and a disc problem, then time and cage rest along with pain relievers should/could resolve the loss of neurological function to her rear legs and tail. If this is the condition, it is very much a blessing that she is able to urinate and defecate normally!
Secondly, the way to help her walk right now is to "sling" her. With a band of cloth (towel, scarf, necktie, etc.)pass this under her belly just in front of her rear legs. Then when she goes outside someone can hold up her rear end (helping her to walk with less pressure on her rear legs). There are products just for this that you could order online or purchase in pet stores.
I hope that I picked up your request within a good time frame for your family. Please let me know if you have any further questions.
Dr. Barbara
Customer: replied 1 year ago.

Hi Dr. Barbara

Thank you for your quick reply and your insight on what we could do for her.

However it was decided by my family using information from the vet and the possible suffering that she was in, that Ellie would be put to sleep, so she passed away yesterday evening 20th April 18:00 GMT.

Once again thank you for all your insight, you really helped me understand what she was possibly going through.

James

Expert:  Dr. Barbara replied 1 year ago.
Hi James,
I'm so sorry for your loss of Ellie. For most of us, our pets are very much a part of our families, and their loss is devastating for awhile. I hope that you all have the support you need to go through this time of grieving.
Throughout our pets' lives we are making decisions for and about them, with love. Part of this is deciding when their suffering (either with the condition or necessary tests and surgery) is too much to put them through, and in veterinary medicine we do have the option of euthanasia. Sounds like your family made a very difficult choice, but a most loving choice for Ellie.
Thank you so much for letting me know, and thank you also for your very kind rating and bonus. . .both greatly appreciated!
If I can be of any further help to you, please let me know. This thread does stay open and available for awhile, even after a rating.
In empathy,
Dr. Barbara

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