A couple of years ago I took my dog to the vet and had his xrays done and we found out that he has HD on his right hip. He really didn't show too much sign of discomfort in the past two years, but recently since I've had him neutered (last month), he's started to limp a lot. After about 15-20 minutes of walking on straight, soft ground, he will start to visibly limp and favor his right hip. He also is very tense when you touch his right leg, so I'm thinking he might be in some pain.

I've been giving him Dasuquin (glucosamine, chondroitin, MSM) for the past 1-2 months, but I know that it takes some time before you see any change. Since he started limping, I've stopped taking him on very long walks because I wanted to give his hip a bit of a break. He's five years old now and I really don't want him to have to go through this for the rest of his life. Is there anything else I can do to help him besides surgery and pain killers? Or are those two options the only things left for me? I tried buying him one of those heated pads, but he never used it even once. Plus, I live in Arizona and it doesn't really get that cold.

I'm thinking about taking him to the vet again, but I'm honestly not sure what else they could do for him at this time.

I appreciate any help you guys can give.

- Ali

You'll want an ortho workup and a talk about new x-rays, how bad the related OA changes are, etc.

Are you familiar with Adequan (an injectable)?

http://www.caberfeidh.com/Adequan.htm

You'll want to discuss what surgeries are possible with the ortho vet, too, so you know what there is to consider.

There are NSAIDs, too, of course, which you will want to read up on very thoroughly before starting, if the vet recommends one.*

He's getting walks on surfaces with "give," right? (You don't want his joints to be deprived of range-of-motion and the crucial synovial fluid that gets into the joints with it.)

He's on daily fish oil? How much? And natural (not dl-alpha) E?

The level of pain you're seeing (limps, tenses on touching his leg) indicates that it's time for new x-rays (to ascertain OA changes) and a discussion of all the above, and maybe a talk about the possibility of non-NSAID pain meds (maybe Tramadol) for certain times, or if he is not a good NSAID candidate.

I'm so sorry to hear this. I'd want to talk to an ortho vet with Adequan experience, myself. JMO!




* There are many detailed threads here, outlining pre- and during-protocol safety measures if an NSAID is decided upon.

Edited by Connie Sutherland (03/07/2012 03:38 PM)
Edit reason: asterisk added

He walks mainly on grass and loose gravel. Also, he's not on any fish oils but his food is Evo Salmon formula which contains a decent level of fish oils.

I just noticed that his right hip has swollen and is visibly bigger than the left. I've scheduled a vet visit for Monday. I'll make sure to ask her of all the things you mentioned!

Thanks again, Connie!

This sounds possibly acute to me ..... more acute than the gradual OA changes from HD that I was thinking of .... can you get the dog in tomorrow, maybe?


Not a health professional, but visible swelling and limping would make me want an exam asap.


Please let us know how it goes.

Well I took him to the vet (regular vet, not ortho) last week and we took some new x-rays, and it looks like his hip dysplasia has progressed significantly since the last time we took x-rays (last images were taken in 2008). At this point, the vet recommended anti-inflammatory and pain medication to reduce his discomfort for now, but she said that he would have to be put on permanent natural anti-inflammatory supplements to reduce his discomfort over the years. She did recommend hip replacement surgery as an alternative option, but she said that it generally costs around $2500-3000. I did ask her about Adequan and she said that it would be beneficial, but the costs are around $240 a month to start, so in the end the surgery would still be my cheapest option.

She put him on 75 mg of Rimadyl (one pill, twice a day) and 300 mg of Gabapentin (one pill, twice a day) to quickly ease his pain/discomfort. The only issue I have with Gabapentin is that this is the human form (bought from a grocery store pharmacy) and I haven't heard too many good things about Gabapentin, so I'm not sure if I want to continue keeping him on it.

I'm really considering going through with the hip replacement surgery, but unfortunately I don't have the funds at the moment. It will be another year before I can save up to pay for it. I'll have to figure out how to ease his pain in the meantime.

I'm sorry about the diagnosis.

Were you fully apprised of what side effects to watch for re: the NSAID?

Was the pre-protocol bloodwork done and plans made to repeat it regularly to compare kidney and liver values against the pre-protocol baseline?

She actually did not tell me of any side effects, so I'm not totally sure. I know the Rimadyl is not a permanent drug. It's just to give him a good start and then I'm supposed to switch him to Yucca Intensive which contains steroidal saponins.

There was no bloodwork done on him because he had his bloodwork done last month prior to his neutering. She mentioned nothing about continual check ups. Is this mainly for taking Rimadyl?

There are a couple of other threads going on right now about the pre-NSAID bloodwork and the side effects to be watching for.

http://leerburg.com/webboard/thread.php?topic_id=31987&page=1
Scroll down to my post that starts with "There's no way I'd still be doing that vax on a ten-year-old dog" (4th post down):

QUOTE: "Dogs are much more vulnerable to NSAID side effects like ulcers and kidney and liver damage than humans are (and this includes aspirin). No NSAID protocol should be commenced without blood work. I imagine the vet was relying on the November bloodwork for his baseline?

BTW, Deramaxx is one of the two NSAIDs I personally would choose first for any dog of mine who needed an NSAID to provide quality of life. In fact, I have a senior on daily Deramaxx (deracoxib). That doesn't mean that it's any less crucial to do pre-protocol bloodwork (and regular re-testing during the protocol) or that the side effects suggesting GI distress can be ignored. The most common side effects of NSAIDs in dogs are nausea, vomiting or diarrhea, and inappetence. "

Also, if you search using NSAID for your search term (upper right, "advanced search," and expand your time to a couple of years) you'll find that your vet should have carefully explained what to watch for and why." END QUOTE

Or here is the FDA warning from http://www.fda.gov/AnimalVeterinary/SafetyHealth/ProductSafetyInformation/ucm055434.htm ....

Veterinary Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are used to control pain and inflammation. Inflammation - the body’s response to irritation or injury - is characterized by redness, warmth, swelling, and pain. NSAIDs work by blocking the production of prostaglandins, the body chemicals that cause inflammation.

In companion animal medicine, approved veterinary NSAIDs are used to control the pain and inflammation associated with osteoarthritis in dogs and horses. Some veterinary NSAIDs are also approved for the control of postoperative pain in dogs and cats. There are potential risks associated with the use of NSAIDs. Veterinarians and pet owners should be aware of the following facts:

All dogs and cats should undergo a thorough history and physical examination before beginning NSAID therapy.
Appropriate blood/urine tests should be performed to establish baseline data prior to, and periodically during, administration of any NSAID.
Common side effects include vomiting, diarrhea, not eating/eating less, and lethargy. If your pet experiences any of these potential side effects, STOP administering the medication and contact your veterinarian immediately.
Veterinary NSAIDS may be associated with gastrointestinal ulcers/perforations, liver, and kidney toxicity.
Serious side effects associated with the use of NSAIDs can occur with or without warning and, in some cases, result in death.
Use with other anti-inflammatory drugs, such as other NSAIDs and corticosteroids, should be avoided.
Patients at greatest risk for kidney problems are those that are dehydrated, are on diuretic treatment, or have pre-existing kidney, heart, and/or liver problems.
NSAIDs can cause stomach or intestinal bleeding.
Risks associated with NSAIDs are detailed on the package inserts and Client Information Sheets that accompany all veterinary NSAIDS dispensed to clients. A Client Information Sheet should always be given to the client with each NSAID prescription. Pet owners should read this information carefully. Owners and veterinarians should carefully consider the potential benefits and risks of using an NSAID and other treatment options before deciding to use an NSAID. END

All of this should have been carefully gone over with you by your vet.

This in no way implies that NSAIDs aren't often magic bullets, because they very often are. There are many dogs who would have had to be put down long ago but who have quality of life because of an NSAID. However, it does tell you how remiss it is of any vet not to have followed these guidelines.

I have an HD/OA senior on Deramaxx, and his continued life and comfort are a direct result of it, but each of those safety steps were (and still are) followed.

I finally got a chance to talk to my vet and she said that there shouldn't be any issues as long as I give him the meds with food. She said since it's only temporary, there won't be a huge effect on my dog. I haven't noticed any change in behavior either (vomiting, diarreah, etc.). The only thing I noticed was that his eyes are watering a lot more since I've started him on the meds. I'm not sure if I should be too worried about this or not.

You'll see from the FDA NSAID warning (above) and from every authoritative vet med site and handbook that the potential side effects and the warnings about pre-testing and what to watch for in your dog are not restricted to long-term protocols.

I'm not arguing with you or speaking against your vet, because you have now read here what you need to know, and what to watch for.

But I don't want someone else to read here that "with food" or "temporary" mean that the warnings about what to watch for and the recommended pre-testing refer only to long-term usage. They do not.



You aren't giving the human form of the liquid gabapentin, right? (It contains xylitol, toxic to dogs.) I don't know what made me remember that .... I was thinking about runny eyes.


I found that an unusual side effect of gabapentin in humans, at least, is watery eyes -- should be reported to physician.

http://www.drugs.com/pro/gabapentin.html



How is the dog doing? Seeing any lessening discomfort, I hope?