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Help! Pain Medication for Large Breed Limping Dog

DextersMOM
June 30th, 2011, 01:22 AM
Hi! I have a year and a half old Tibetan Mastiff who's 110 lbs. He's generally active and is still a lot of "puppy"! About a week ago, I noticed he was limping and it looked like one of his front legs was injured. He only whined when he laid down and got back up. The only thing I could think of was the night before, I came home through the back door where he "guards" and caught him by surprise. He jumped up real quick on the kitchen tile and may have strained a muscle.

I took him to the vet two days later, and got xrays taken. Everything looked very good. The vet said the xrays would show if there was any problems with ocd, etc. Both of his parents had OFA good and normal ratings. The vet prescribed Deramaxx. I started giving my dog the Deramaxx and he did not respond well to it. His eyes became bloodshot and watery. And he started pawing at his face the second day into the medicine. He slept all the time and wouldn't eat. He was constantly licking his lips and nose. His third eyelid started showing up in both eyes. I could tell the Deramaxx helped his pain, but he was not himself.

I called the vet and explained his symptoms. I took him off the Deramaxx and I can tell he's not miserable, but he just stands and hardly walks at all. He's now lifting one back leg for a few seconds and then changing to the other back leg for a few seconds. He's extremely hesitant to lay down. I went to the vet this morning to get a new medication, and she prescribed Tramadol. I gave him 100 mgs around 9 am. He acted the same when I left for work at 2pm. I put him in his crate to keep him from walking around or standing on his legs. When I got home. He was laying in the crate, stiff as a board and would cry. After about 40 minutes he got slowly got up and started whining. He is extremely hesitant to move. He mostly stands up without moving or he's laying down. He seems to be reacting and moving even slower than he was before I took him to the vet, and he still isn't eating. He's been drinking water like crazy! And tonight when he way laying on the kitchen floor he peed. Any thoughts, comments, or suggestions? I would really appreciate another opinion. Thank you!

growler~GateKeeper
June 30th, 2011, 01:58 AM
Have you spoken to the vet about the symptoms Dexter is displaying while on Tramadol? Perhaps the dosage needs to be adjusted by the vet or he needs something different yet again.

Good luck & let us know how he's doing. :goodvibes:

Melinda
June 30th, 2011, 05:17 AM
what about just medicam or plain old coated aspirin for inflammation?

hazelrunpack
June 30th, 2011, 10:13 AM
Did they check him for tick-borne disease, DextersMOM? Rotating lameness and lethargy are classic symptoms, and we've had dogs lose bladder control when they had a bad case of anaplasmosis or Lyme's.

There is a snap test put out by Idexx Labs that many vets in tick country use--it checks for Lyme's, Ehrlichiosis, and Anaplasmosis as well as heartworm and the test results can be seen in minutes (in-house). If it's not available in your area, they can do blood titers, which take longer, but they might start your dog on meds right away while they're waiting for results. Even a CBC can sometimes give you an indication of what's going on--for example, when our dogs have anaplasmosis, the platelets and WBC counts are both lower than normal. If it's something tick-borne, you'll likely see very quick improvement in the symptoms once they start him on the antibiotics...

We've also unfortunately had some experience with elbow dysplasia. One of our first setters started showing symptoms at 9 wks and we had his elbows xrayed by our regular vet immediately since we knew setters tend to be prone to elbow dysplasia. Everything looked normal to the vet on the xrays right up until we finally asked for a referral to an orthopedic vet. Yet the specialist saw things that general practice vets just aren't trained to see, and our dog did, indeed, have elbow dysplasia. The dog's dam and sire were OFA normal. So, if the tick disease is ruled out and the problem continues, see if you can get a referral to a specialist to check out those joints.

Hope your dog feels better soon, DextersMOM. :goodvibes:

Myka
July 1st, 2011, 02:34 AM
I think your vet is missing something, I would be looking for a second opinion with a different vet. Not saying your vet isn't competent, vets miss things sometimes. Prescribing pain medication without figuring out the cause of the pain or even the area of the pain would be concerning for me. It sounds like he is getting worse instead of better, and that's not a good sign.

DextersMOM
July 1st, 2011, 05:22 PM
So the past day I've been giving him 2 tablets every 8 hours. Last night it didn't seem like enough. He's urinated on himself again, and four hours after he took two tablets, he was whining again. So I gave him one more to hold him over. He slept for 3 hours and woke up this morning at 2:30. I gave him another tablet and he was still whining at 3:30. I gave him one more, and two hours later he went to the door to go outside to pee. He was walking around and wanted to go do more Dexter stuff... like bark at the neighbors and lay on the couch. Since he whined so much last night, I brought him to the vet at 8 am when they opened. They did a blood draw and I asked for a copy. Everything looks normal, except for his high white blood cell count which is 49.44 and his red blood cell count was low (4.93). They also completed an Idexx HWT/ Tick 4DX and everything came back negative. His front leg joints were hot, and Dexter didn't whine about being touched, poked or proded. There was no swelling other than a little bit in his front legs. He has a slight temperature of 102.7 and he's lost 9 pounds since he wasn't been eating. He's down to 101 lbs. The vet concluded he has an infection, but couldn't determine where it was or what caused it. They wanted to keep him over night for a whooping $450 and give him an iv, catheter, etc. I declined since this morning he was more perky and 450 is a lot, especially when I'll be home the next three days. Before he left they have him sub q fluids and Lactated Ringer Solution (6 ml). He's now taking 3 Tramadol every 8 hours and 2 1/2 tablets of Doxycycline every 12 hours. The vet said to give him about two days to see a difference since tablets take longer to absorb. Here's the complete panel for those interested:

ALB 2.4
ALP 101
ALT 24
AMY 628
TBIL .2
BUN 7
CA 10.3
PHOS 5.1
CRE .7
GLU 120
NA 155
K 4.7
TP 6.8
GLOB 4.4
WBC 49.44
RBC 4.93
HGB 11.5
HCT 33.78
MCV 69
MCH 23.3
MCHC 33.9
PLT 344
PCT .36
MPV 10.5
PDWS 15.5 FL
PDWC 41.8%
RDWS 43FL
RDWC 15.5 %
LYM 3.86
MON .55
NEU 42.24
LY% 7.8
MO% 1.1
NE % 85.4

Myka
July 1st, 2011, 06:32 PM
Has the vet suggested ultrasound to look for infection? if it is an infection, knowing where it is could be very important as treating some infections with antibiotics without opening up the abscess can have detrimental effects.

hazelrunpack
July 1st, 2011, 07:13 PM
Do you have the normal ranges listed on the lab work, DM? How far out of normal were the counts for the red and white blood cells?

I'm glad your vet put him on doxycycline. I've heard of dogs in IL contracting Rocky Mountain Spotted Fever. Another thing we've seen up here (don't know if it's in your area) with similar symptoms is leptospirosis. Both of those will also respond to doxy (we treat lepto with a combination of doxy followed by amoxicillin).

I hope the doxy does the trick and he's back on the road to health soon! Keep us posted, pls!

DextersMOM
July 1st, 2011, 07:47 PM
Myka- The Dr didn't suggest ultrasound.

Hazelrunpack- The white blood cell count was sky high. The normal range is 6,000-17,000 and Dexter was 50,000. The red blood cell count was slightly low, but he hasn't been eating at all the past week except for eggs, so I imagine that would account for it

DextersMOM
July 1st, 2011, 07:57 PM
Also, his lymph nodes weren't swollen. Kidney and liver function were normal. Good to know especially after his bout with Deramaxx.

hazelrunpack
July 1st, 2011, 08:03 PM
Babesiosis is another tick-borne disease and it can lower RBC counts. I believe it also responds to doxy.

Yes, I have ticks on my mind--we're in the midst of the Icky Tick Season here. :o But the symptoms do fit... We've dealt with so much of it over the years that it's the first thing we check for when our dogs start exhibiting symptoms.

At any rate, I hope you see marked improvement over the next few days! With our guys, relief from symptoms starts in just a few days. I hope that's true with Dexter, too! :goodvibes:

Myka
July 1st, 2011, 08:56 PM
Well it definitely sounds like an infection of some sort, not an injury. So I don't think slipping on the tile was the cause.

What have you tried feeding him? Boiled chicken? Brown rice and beef/chicken broth? Baby food? Canned dog food? As long as he doesn't have a beef intolerance it could help bring up his red blood cells.

DextersMOM
July 1st, 2011, 09:42 PM
I hope he'll be feeling better soon too!!!! It feels like he's been sick for months!

He's been eating raw eggs and I fed him beef earlier. He didn't eat as much as I would have liked but it is something. He'll be stinky though. Beef gives him gas :oO

DextersMOM
July 3rd, 2011, 07:09 PM
So it's the third day Dexter's been on Doxycycline, and he's still on Tramadol. I can tell he's feeling better, but he hasn't made a complete turn around. He refuses to eat, except a few times he's eaten some eggs. I made him eat some beef to at least get something solid in his belly. He'll go outside to go to the bathroom. My mom and brother came to visit yesterday, and he was so excited. I can tell when he's happy, because his tail curls over his back. He was more himself. He's still been sleeping, and his legs are still stiff. The vet isn't open until Tuesday. I think this is taking steps in the right place, but I wonder if it'll give him the recovery he needs. Thoughts?

hazelrunpack
July 3rd, 2011, 07:29 PM
IMO, as long as he's showing some improvement I think it's best to stay the course till you talk to the vet again on Tuesday. Glad to hear he's feeling better! It may just take him a little longer to respond completely if he has a tough infection.

As I understand it, tramadol can cause loss of appetite in some dogs taking it--especially in the first few days. So the fact that he's not eating much isn't too surprising. Is he still getting plenty to drink? If he's not much in the mood for water, some low-sodium broth might tempt him to drink--I just boil a chicken breast in water till the meat falls off the bones, then strain the broth (save the meat for tempting him to eat later but discard any bones).

DextersMOM
July 3rd, 2011, 09:25 PM
Thanks! I just wish he was completely better! It's tough watching the process. He's been drinking water regularly. I'm also giving him ice, which he loves, to change it up a bit. He'll eat eggs on his own, and I'm practically making him eat beef.

He's just so sad!! I wish this sickness was over!

Myka
July 5th, 2011, 09:22 PM
How did the vet appointment go today?

DextersMOM
July 6th, 2011, 11:10 AM
I didn't take him, but I called her. She said his progress sounded good. I'm just going to finish the anti- biotic meds. He went on a walk last night!!

hazelrunpack
July 6th, 2011, 11:17 AM
Excellent! How long will he be on the antibiotics?

DextersMOM
July 8th, 2011, 12:44 AM
He's on them until then end of the month. We're kicking this infection to the curb!

hazelrunpack
July 8th, 2011, 10:03 AM
Good! :thumbs up If it does turn out to be something tick-related, a longer course of antibiotic is a good idea. Is he still improving? :fingerscr