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Caring for a Three Legged Dog or Cat

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Senior tripawd dog has problems with walking
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Forum Posts: 7
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13 June 2020 - 8:41 am
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Hello to everybody and thanks for this forum! I just found this great community by chance, though i have a tripawd dog since more than ten years and a tripawd cat since 4 years.

My dog Teka was a spain stray dog who had a severe fracture on her front leg, probably due tu an accident when she was a puppy. When she came to switzerland she was about one year old an her leg could not be safed anymore, so it was amputated. She always was a very active dog and loves to run. Many years we went for long walks and hikes together. Since a few years now, we have to go slower, the walks became shorter, I got her a stroller for longer walks. So good so far. I have her on pain medications on and off, depending on how she is (I`m a vet myself – but with my own dog I`m more just a dogowner;)).

4 weeks ago she suddenly startet to collapse with her remaining front leg and could rarly walk anymore. With a lot of painmedication we could just manage to go to the garden and from one bed to the other. After taking x-rays and CT it was clear she has arthrosis in both, ellbow and shoulder, what really isn`t a suprise, and a severe inflammation in the shoulder. So I had a specialist infiltrate her shoulder joint with cortison and local anestetics. For the first time it worked really great. She didn`t collapse anymore and could walk a lot better and I could reduce the pain medication. After about 2 weeks it startet to get a little worse again, but after changing painmeds once more it seemd to be stable. Today she suddenly startet to collaps again with her remaining frontleg and now we are about the same that she nearly can`t walk anymore.

At the moment I have her on Onsior and Gabapentin (and Metimazol since its gotten worse today). I take her to osteopathy regularly and work with Tellington Touch myself.

Maybe anybody has made similar experiences or any ideas?

I know days are counted, but I just hope to become her stable somehow.

(I`m really sorry for my english)

The Rainbow Bridge



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13 June 2020 - 12:54 pm
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Hi Teka and family, welcome! We are sooo happy you joined us and look forward to getting to know you both. Your English is great! No apologies necessary. Your future posts won’t need approval so post away.

I’m sorry to hear Teka isn’t doing well right now. She is so lucky to have you as a parent! As far as her mobility issues, it’s not all that uncommon for a situation like this to develop but the good news is that there are lots of things that can be done. 

It sounds like you have the pain control side of things covered pretty well but my guess is that her protocol may need some adjustments. It’s too bad the cortisone effects weren’t longer lasting. What is the dose of Gabapentin she is on? Many times we find that Tripawds’ pain management isn’t as robust as it could be, especially when it comes to daily management. One example of an older Tripawd’s pain medication protocol looks like our Wyatt Ray ‘s. He is 11 years old, a 75-pound rear leg amputee since he was 8 months old. He takes

  • 400 mg of Gabapentin 3x daily
  • 750 mg Methocarbomol 3x daily
  • Meloxicam 3.25 mg 1x daily
  • Amantadine 100mg 1x daily at night. 

This is what his veterinary team at Colorado State University prescribed to him, and we adjust it as necessary. 

Has she had any rehabilitation / physio therapy at all? If not, now is the time. A good physio therapy program can make all the difference, and help her get a higher level of mobility back. Here are some examples of rehab success stories. Our Tripawds Foundation may even pay for your first rehab visit if you take her to a credentialed CCRT or CCRP practitioner.

Here is what I would recommend. Seeing as how you are a vet, you may want to connect with our friends at Colorado State. Their Orthopedic Medicine and Mobility team is amazing and they are now doing online consultations (the link has info). 

Alternatively, you may want to reach out to Dr. Robin Downing, a pain management specialist, also in Northern Colorado, or our friend and pain specialist, Dr. Mike Petty in Michigan. I don’t know if they offer long distance consultations but as a vet, I’m sure you would have lots to talk about with them and hopefully get some guidance for Teka.

I hope this helps! Please let us know how she is doing OK? Thanks again for joining. 

It's better to hop on three legs than to limp on four.™
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Forum Posts: 7
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14 June 2020 - 2:22 am
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Hi dear Jerry,

thank you so much for your detailed response. It helps so much to speak with and read from people having similar experiences.

Gabapentin I just restarted 1 Week ago when she started to walk worse. I have her on 100mg three times a day at the moment (Teka is 20kg). I know I could dose her higher up, but I`m a bit careful because when I had her on Gaba last time her liverenzymes started to rise and she already has a high ALT by now:( But probably I need to go higher in the dosage for a healthy liver doesn`t help when she can`t walk….

Thanks for the advice to Amantadine and Methocarbomol. All the life with Teka I was thinking about a muscle relaxation drug. But in Switzerland we don`t seem to have any experiences with this medication in pets. So I`m really grateful for this advice. And also Amantadine sounds like a good plan. I will just tomorrow order it.

I have her every now and then at a physiotherapist, but maybe I should additionally to the osteopathy also start with that more regullarly.  She had had acupuncture also but she was really, really stressed every time, she really didn`t feel ok with that.

Thanks so much also for advice of other vets to get in touch with!

Thank you so much for everything!!!

The Rainbow Bridge



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15 June 2020 - 10:13 am
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Awww you are so welcome! I’m glad this helped and look forward to find out how she’s doing and what works and what doesn’t. My guess is that you’ve got this handled and know what to do to help her feeling good again. Please keep us updated OK? 

P.S. Dr. Downing mentioned to us that Gaba is a really safe drug with minimal effects on the liver. I’m wondering if there was something else that was causing her enzymes to go up? Just curious. Maybe if you get in touch with Dr. Downing you can ask? 

Take care and keep in touch!

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17 June 2020 - 6:58 am
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Thanks again, it is really interesting to read all the information in this forum and the blogs!

My girl is a little better for the moment, probably, because we don`t go for walks at the moment. Unfortunately she gets grumpy about thatsmiley5icon_rolleyes

I got in touch with a specialist for veterinary analgesia here in Switzerland and am waiting for her response for now.

ps: your are probably right, Gaba seems to have – appart from the begining – minimal side effects in dog or its just not knwon by now. In human medcine it is known to have an impact on the liver. Last time we used Gaba up to 300mg three times a day she was also on low dose prednisolon and it might have been the combination of the two who affectetd her liver. But still I prefere to be a bit careful with potential liver impacting drugs….

The Rainbow Bridge



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17 June 2020 - 8:31 am
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Better to be safe, definitely! I’m glad you found a specialist and look forward to learning about how they will treat her. Hopefully she can start going on happy walks again real soon!

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23 June 2020 - 4:46 am
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Hi everybody,

i wanted to give you an update about Teka.

Since she it getting worse and worse despite rising up the doses of medication and after speaking to a specialist of analgesia I will try with prednisolone now instead of onsior. And additionally we try to stabilise the acute situation with opioids (Buprenorphin, fentanylpatch).

Today is the first day she really seems to be depressed…. I don`t know if we will have a lot of time anymore but I just have to try again.

I will also take new radiographs this afternoon to see if ther has anything changed.

Thanks for all the advise in this forum!

Elisa and Teka

The Rainbow Bridge



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23 June 2020 - 10:27 am
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Elisa I am so sorry to hear that. What exactly did the pain specialist say? Just curious.

As a vet, you are able to give her the kind of care and attention she needs to get through this painful episode. You can do this Teka!

We are sending lots of sp_hearticon2 and ((((hugs)))) for better, pain-free days ahead. Please keep us posted.

It's better to hop on three legs than to limp on four.™
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Virginia




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23 June 2020 - 4:27 pm
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Just want to add  ore healing energy  to your sweet pup.  I know it’s hard trying to figure pit a solution.  Clearly you are leaving mo stone unturned and doing everything possible for her.  Without doubt, Teka knows how loved she is❤

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

PS…probably  already checked this out, but any possibility  she could have an issue with her spine, her neck, etc.  Sometimes pinched nerves and things like that can manifest  in the leg.  Jist trying to think outside the box.

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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30 June 2020 - 9:35 am
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Hi everybody and sorry about my late respond.

I was just tooo busy at work and with a lot of sorrows concerning Teka…..

But now I have really good news: she is much better since a few days.The thing that really seems to help is the predisolone. She can walk now much better, we even can go for mini walks (max 10 minutes) and she seems in a lot better mood (me too;)).  I could also reduce the amounts of analgesia she gets.

I`m still a bit carefull about getting too excited because we had so much up and downs. But for now I just have to keep my fingers crossed and enjoy every day I can have her at my side.

The specialist for analgesia was really a delight! She gave me so much advice about different drogs. Apart from the idea to try with prednisolone instead of a nsaid.

But to bridge the time until the prednisolone started to help, i gave her opioids (I`m in the comfortable situation that I can give her injections by my self, but I also orderd a fentanyl patch – which luckily I didn`t need). Since Amantadine needs several days until it has an effect, I also gave her injections with Ketamin in  a very low dose.

Further on she told me to keep Gabapentin on a low dose (100mg 3 times a day) since it makes her rather weak which does not help for her walking at all. (Also the problem I had with the opioids).

She also told me about goldinjection directly into the joint which should help against osteoarthritis. Has everybody allready heard about that?

So far for today. Thanks for all the thoughts and ideas.

Elisa and Teka

Virginia




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30 June 2020 - 9:48 am
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So relieved  to hear how much better Teka is doing!!!  Made my day!😄

You really, really, really are doing such a great job of helping  Teka be Teka.  

Ap glad the Pred seems to be a good solution and, hopefully it will continue  to be!  My Vet said one time the Pred can prove to be a miracle drug sometimes.  Paws crossed that  the “miracle ” conrinues.

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

The Rainbow Bridge



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30 June 2020 - 11:27 am
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Oh I’m so happy to read this update! YES! YAY! WOOOHOO!

The thing that really seems to help is the predisolone.

Can you remind us, what is the difference between Prednisone and Prednisolone? 

But to bridge the time until the prednisolone started to help, i gave her opioids 

Now that is something we need to remember! Was the Ketamine the only one she received? I’m wondering if this is something we can ask our vets to do for us, should we find ourselves in the same situation. 

She also told me about goldinjection directly into the joint 

Woaaah, now this is a new one! I looked up “gold injection for dogs with osteoarthritis” and here are some articles I found. Is this what you are referring to?

VetFolio: Gold Bead Implantation

Pain Of Dysplasia In Dogs Relieved With Gold Treatment, Study Shows

It's better to hop on three legs than to limp on four.™
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5 July 2020 - 4:59 am
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Thanks for all your lovely responds!

Yeah we are still on good ways. She seems to be stable with curent medication (10mg Prednisolone once a day, 100mg Gaba 3times a day, 500mg Metiamzole 2x a day).

She does not really want to go for mini walks, but she loves staying in the garden and just beeing. Hope we can carry on  like this for a while:)

About your questions: (sorry I didn`t get yet how to quote):

Prednisone is the prodrug von Prednisolone. Both of them have the same effect. Here in Switzerland we use prednisolone. Maybe in US Prednisone is used more often?

Yes the tip about Ketamin was really great. It is given in a really small dosis (0.5mg/kg subcutaneously injection). In this dose it does not have the effect of haluzination and cataplexy as we normally know from the usage in anasthesiea when using ketamin (than we need to combine it with an muscle-relaxans).

But I really think what helped most was the prendisolone. How ever….

About the gold: it is not exactly what the articles refer to. The gold bead implantation (in Switzerland also refered as gold acupuncture) is a technique where gold beads are implanted at points of acupucture (normally as soon as I know in the soft tissue). This is used against chronic pain. But I don`t have any experiences with it, just talked once to a acupuncturist who said it`s not logical in acupuncutre to stimulate the same points for a long time.

My speialist of analgesie talked about a new technique wher gold powder is injected directly into the affected joint. (They make a solution with the gold powder and infiltrate the joint with that). I need to look for papers about it. But I think once she stays stable like she is now, we will just go ahead like this.

I don`t want to have her a lot of procedures just for me having the feeling “to have done everything”. I really want her and me to enjoy our time together as long as possible and as stressfree as possible.

The Rainbow Bridge



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5 July 2020 - 1:02 pm
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There’s a lot to be said for just hanging out in the garden and watching nature, what a beautiful idea. You know her so well and have a good handle on her care. I’m so impressed with the pain management ideas. Thank you for explaining. Yes, we use prednisone more often here as far as I know, at least on dogs. 

When you do find more information about the gold injections please share the links here, it sounds fascinating. I hope it works well for her.

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