After this posting
http://leerburg.com/forums/ubbthreads.php/ubb/showflat/Number/234284/page/1#Post234284

I had numerous phone consults and voice mail consults with his vet. Hambone goes this Saturday for a complete physical.

One suspicion is his pain meds are no longer working to keep his pain at a manageable level. He does have spondylosis, wicked bone spurs in the middle of his spine, and bursitis and osteophytes in his front feet. (His front feet are a mess). He is on Tramadol, but we will probably switch to something stronger. As much as I hate to use "harsh" drugs, he comfort level is paramount.

Second suspicion is his thyroid meds need altering. We will be checking his levels again this weekend.

Third, we are part of an experiment that uses higher EPA to DHA ratio of Omega 3 to combat itching, skin problems. It worked, but DHA is for the brain (and is being used now for older dogs with cognitive issues) and since we switched, he is not as quick to learn or as patient. We were concerned that would happen, so now we need to discuss whether to end the experiment.

I know he is failing. His spine is fusing and he is having difficulty maintaining a sit (hindquarters shiver and he slides) and he is having trouble with bowel movements in that he really has to strain to get his poop out. He is also losing muscle mass in his hind quarters and the swaying is more pronounced now.

I am leaning toward allowing Metacam or Deramax (?) for his pain meds, but I will bow to the experts on this forum if you can give me some advice. In this instance, with his physical problems, should I allow Rhymadol? (sp). I know you can't give medical advice, but opinions are allowed and then I will (as always) make my own choice for my boy in his best interest. I need and want all the information I can get.

Metacam I have used on Teagan but am working with....god, I can't remember. She just gets it every night - the OTC stuff, anyways, b/c that works and should be easier on her kidneys.

Metacam is tough on the kidneys, which is something to be aware of, but I think in Hambone's case you also have to weigh the devil you know (his pain) with the devil which may or may not come (kidneys).

I have given Metacam long-term to an animal, a disabled bunny I had - it helped him a great deal.

Connie may be able to confirm this, Jo, but my understanding of Tramadol is that it is a stronger pain medication than Metacam and Deramaxx. So you *might* be taking a "step down" in terms of pain management if you use one of the NSAIDs.

As far as NSAIDS go, Metacam and Deramaxx would be my first choices. I have used Metacam and it is very effective for True's joint issues.

I found this web site, which gives a short overview of all the pain medications available for dogs and cats:

http://www.2ndchance.info/pain.htm

Fentanyl, which is on the list, may be something to ask your doctor about. I know it is a strong, effective pain medication that we used both before and after major surgeries. I have no idea if this would be helpful, or safe, for Hambone.

One thing I noticed mentioned under Tramadol is this:
"Administering tramadol with NSAIDs, or mu agonists increases the pain relief."

Someone else may have experience to say if this is effective and it may be worth asking your vet about.

 Quote: sarah morris

One thing I noticed mentioned under Tramadol is this:
"Administering tramadol with NSAIDs, ..... increases the pain relief."

Someone else may have experience to say if this is effective and it may be worth asking your vet about.

I think it's worth discussion.

Why Rimadyl? I've never heard any argument that it was more effective than the NSAIDs with safer histories.

Remember that Ultram is not an anti-inflammatory, so it may well worth considering the NSAID action in addition to the Ultram additional pain relief.

Not a medical opinion.

P.S. I am so sorry, and he is on my mind a lot.

Thanks for the link and the conversation. I have taken notes and plan on a serious discussion with Doc. I already told him to have literature, studies, percentages, etc available when we get there Saturday.

And, Connie, thanks for thinking about Hambone. He is my boy. He and I share an almost telepathic link and I have never had this with any other dog. It hurts me to see him like this and I can't take the pain away. I can just hold him and tell him through my hands I am sorry.

My old dog used Quadrisol. My understanding was that it was safer, long term, than Metacam (plus Metacam upset her stomach). Although it is still an NSAID. Do some research - this was 4 years ago now and I forget what I was told about it - but it definitely helped her.

Hambone had his visit. AFter the physical exam and manipulations, he is almost certainly fused from his tail to just before his tuck. He definitely has less muscle mass on his right side and now arthritis in his neck.

We chose a low dose of Rimadyl--(he's been on it before about 5 years ago for a shoulder injury) so we have his records.

It is fast acting on him and the dose is low enough to not cause problems but high enough I should see some relief for him. We have a 5 day trial. If it works, we keep him on a low dose. If it doesn't, we find a different drug to work with.

We keep him on his EPAHA ratio because he isn't itching, but I am going to add more fish (sardines and salmon) to his diet. If I have done my math correctly, it shouldn't mess the ratio up.

He also has balanoposthitis (prepuce infection AGAIN!) so he is on Keflex for that.

I have a stupid question but you will understand why I ask in a minute. Don't neutered dogs have the INCAPACITY to mate? If that is true, they missed something with Hambone. He mounted and penetrated Lucy before I could stop him. Now, Lucy has a discharge and she is on Keflex too.

WHAT else can happen?