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Dr. B.
Dr. B., Board Certified Veterinarian
Category: Vet
Satisfied Customers: 17071
Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
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Hi there, I need some help with understanding grasilis disease

Customer Question

Hi there, I need some help with understanding grasilis disease as it has been diagnosed in my German Shepherd
Can anyone help me please?
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. B. replied 2 years ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today.

Do you have any specific questions about the condition that I can answer for you?

Customer: replied 2 years ago.
Thanks for getting in touch. Our 5yr old GSD was diagnosed earlier in the yr with this condition. He was on meds for pain but started to suffer d&v. Our vet advised to discontinue. We limit his exercise but every so often he screams out in pain :(
For the last few months we have had constant accidents in the house. We have other dogs so assumed it was our elder dog.... However after lots of watching and separating we have discovered that it is indeed Jed the others are dry. It makes no odds if we let him out before during and first thing there is still mess. Jed was such a proud dog and would never have an accident. Now we are wondering if his in in continence is linked with his grasilisc disease.
We have a young son and don't want to just give up but day in day out it's tough going :( I don't want him living in agony so what's the best to do?
Expert:  Dr. B. replied 2 years ago.
Hello again,

I am so sorry to hear that your lad is so young and carrying this diagnosis. This is a terrible condition and I have to be honest and tell you that all the studies do date have shown very little promise. Medical management with standard pain relief often doesn't get us optimal results. And even in those cases where surgery was performed, those dogs only were pain free for 6 months at most. So, it is a terrible condition that we really do not have good treatment options for.

In regards ***** ***** accidents, I would be highly suspicious that it is related to his condition. Often we see dogs start to have accidents in old age because sore joints make them try to delay having to get up to go (putting off the discomfort as long as possible, only to get caught out when urgency increases). And if he has this condition, then he is likely doing the same though not because of the joints. Just trying to delay having to face the discomfort and then having an accident when he delays too long.

At the moment, the main treatment for these cases is rehabilitation therapy. For example, ultrasound therapy, massage, home therapeutic exercise programs (ie stretching, etc). This is often coupled with multi-modal pain relief to try and at least reduce their discomfort. I would note that since he did struggle with the medication his vet gave (which I suspect was a non-steroidal anti-inflammatory like Metacam, Rimadyl, Onsior, or Previcox), we may want to consider some alternatives that don't affect those same adverse pathways. Other potential options would includes muscle relaxants, Tramadol, Bupenoprhine, or Gabapentin.

Furthermore, since his treatment plan doesn't seem to be meeting his needs, I would suggest that you may want to have your vet contact your local vet school specialists to discuss a pain management plan. If you are near Edinburgh, then I would note that their vet school does have a very good pain specialist (More Info Here) on staff As well, Glasgow Vet school also has a Pain Clinic (More Info). So, if you are local to either, these may be options. Or if may be worth seeing if you vet knows of any closer to you. In all cases though, I would note that you do need your vet to contact the specialists (since they cannot legally prescribe treatment to a case they have not personally examined).

Overall, this is a terrible condition that isn't well understood and treatment trials thus far have not give us the results we would hope for. Therefore, at this stage, I do think it is worth trying some of the above to manage his pain if possible. That said, if you do try and
Jed just still cannot do those things that make doggie life worth living, then we'd have to consider letting him go because neither of us what him to be living with chronic progressive pain.


I hope this information is helpful.

If you need any additional information, do not hesitate to ask!

All the best,

Dr. B.

-----------------------------------------------------------------------------------------------------------------

If you have any other questions, please ask me – I’ll be happy to respond. Please remember to rate my service once you have all the information you need. Thank you! : )
Customer: replied 2 years ago.
Thank you so much for your thorough reply. He was under the queens veterinary college in Cambridge. He was taking carprofen. It's such a difficult decision... I know animals hide pain so it's just difficult to know when the time is right? How do we know/decide?
Expert:  Dr. B. replied 2 years ago.
You are very welcome,
Carprofen is the generic name for Rimadyl, which is one of those non-steroidal anti-inflammatories that we can see GI effects in sensitive dogs. Otherwise, while it sounds like Jed is in good hands, I would consider a wee word if they have him on no pain relief at this point. The specialist in charge of his care may be able to speak to their anesthesia service (as they specialise not just in anaesthetising animals but also pain management for patients). That way you can make sure you are addressing any pain issue that he cannot tell us about. And its especially worth doing if he has these screams of pain and accidents he is having.
Otherwise, the decision to let a dog go is never an easy one to make. The key to knowing when it is time is all down to Jed. You need to look at his quality of life, whether he is doing those things that he has always loved. If he can still do them, enjoy time with you, and is having more good then bad days; then its not time and we can try to keep him comfortable for as long as possible. But if those slip away and he is just coping and getting through the day, then we would have to consider that it is time to let him go.
Please take care,
Dr. B.
Dr. B., Board Certified Veterinarian
Category: Vet
Satisfied Customers: 17071
Experience: General practice veterinary surgeon with extensive experience in a wide range of species.
Dr. B. and 2 other Vet Specialists are ready to help you
Customer: replied 2 years ago.
Thank you so very much we will make another appt with our vet. Happy new year and thanks again
Expert:  Dr. B. replied 2 years ago.
You are very welcome,

I do think that is the best course of action here.

All the best for Jed & yourselves in the new year,
Dr. B.

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