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Weakness in back leg - 6 months post-op
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Member Since:
8 February 2024
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8 February 2024 - 8:52 am
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Hi,

I have a 6 year old Saint Bernard/Bernese mix. In June, I found out that he had osteosarcoma in his back leg. I opted for amputation since he’s young and we caught it quickly. He was evaluated at the Oncology clinic to see if he could function with three legs before we amputated because he did have early stages of arthritis in his front right leg. I was told that despite his arthritis, he would still be able to function with three legs.

I also was going to follow through with the chemo; however, after his first treatment his platelets remained very low, so the vet put him on prednisone. They didn’t provide me with any diet plan and he of course gained weight. I only followed through with a second dose of chemo, but decided that if he needed to be on prednisone while taking chemo, the weight gain from the prednisone would be more detrimental to his remaining leg.

He’s been doing wonderfully up until this winter. His arthritis started acting up and I couldn’t start his medication for that because he was still being weened off the prednisone. As an alternative to the meloxicam, the vet suggested that he start Cartrophen and Librela. Now, after being off prednisone for a few weeks, he’s taking meloxicam, cartrophen and librela. 

In the last week, he went from having issues to getting his back end up outside, to having issues getting up inside, to not having any strength in his remaining back leg at all.

Has anyone experienced sudden strength loss in their pet’s remaining limb? My dog doesn’t seem like he’s in pain but I am getting no where with my vet in terms of reasons/expectations about his back leg recovering or how to help him. 

Thank you!

Virginia







Member Since:
22 February 2013
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8 February 2024 - 9:48 am
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Welcome Kiersten. First of all, want to say it's wonderful to hear how well your pup has been doing up until this latest challenge. You obviously are giving him excellent care and are a great advocate for him.

My first suggestion would be to get an appointment with a Certified Rehabilitation Specialist. The Tripawds Foundation will even pay for the first consult.They truly are experts at identifying causes and coming up with solutions.

What has the activity of your pup been like? In addition to arthritis, it may also be that he has done too much in terms of activity. It's best that he has several short walks a day, not more than about 15 minutes as opposed to Long walks where he can overdo.

Also, massage up and down his neck his shoulder and his spine area does she show any areas of tenseness? Sometimes a back leg issue can be related to a spine tweak of muscle.

FWIW, I have just started my tripawd on  Librela in conjunction with Carprofen forvreally bad arthritis. He just had his first injection so I can't comment on any results yet.

, I would try and keep your pups activity to a minimum until you can get that consult with the rehabilitation specialist. Let us know if you have any trouble finding one and maybe we can help out, okay?

Take care and stay connected.

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



Member Since:
25 April 2007
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8 February 2024 - 11:16 am
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Kiersten, welcome. What's your pup's name?

So you mentioned he's on Meloxicam and Carprophen? That's 2 NSAIDs, typically not given together. 

Oftentimes this happens because of a muscle strain and general soreness. Your dog's a big guy and moving in all different ways that tax his body. Could he have slipped and pulled something? If that's the case, adding in a muscle relaxer called Methocarbomol may help him start to feel better. 

Librela is a really great med for most dogs with OA, but it may not be as effective in all. How long ago was the injection? I don't want you to panic, or assume this is the case with your dog, but I have recently learned from a rehab therapist that there are some rare cases where dogs who are taking it are experiencing hind end weakness related to an underlying neurological condition that hasn't been diagnosed. This article is written by a very well known veterinarian I hugely respect. It's worth reading and discussing with your vet asap.

It does sounds like he needs an evaluation by a rehab therapist if your vet doesn't have a plan to help him regain mobility. They can also give you better weight loss instruction. Losing that excess weight will make a huge difference in his mobility too. If you want to PM me your location I can help find one for you.

How are you helping him get up? Is he toileting on his own? 

Stay strong, you can do this and you will both overcome this hurdle! We are here to support you!

Livermore, CA




Member Since:
18 October 2009
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8 February 2024 - 6:29 pm
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I wanted to throw out there that prednisone can cause muscle wasting so may have made him more susceptible to injury.

My current Tripawd is a little Pug mix who lost her back leg at 7 months old to a car accident, she is now 9 years old.  About a year and a half ago she hurt herself- I thought she had blown out her knee because she was scooting on her butt and wouldn't go up any stairs, even the little stairs up to my bed.

My regular vet diagnosed a strain in her iliopsoas muscle in her remaining hip.  We went off to see a rehab vet and got some treatment, got her on an exercise program and started her on a muscle building supplement called Myos.  I really saw improvement once she was on Myos for a few weeks.   She is little, only about 15 pounds and she started gaining weight partly due to the reduced activity.  I cut the Myos dose down trying to reduce calories... sometimes it seems most of her calories are from supplements!   At her annual rehab vet check up last October I was told to go back to the full dose of Myos and we actually were prescribed a vet strength version- it has some extra something in it...I'm traveling right now so don't have access to the jar.  We also have started adequan injections and she has had a chiropractic adjustment.  She really perked up after the first week of doing the adequan loading dose series. She had her first chiro adjustment about 2 weeks ago and after being a little sore for a day she is moving more fluidly.

Although the rehab vet 'prescribed' all the treatments at the same time we decided to introduce them one at a time so we could tell if each individual med, supplement or treatment was helping.

 

Karen and the Spirit Pug Girls and Boy

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo


Member Since:
8 February 2024
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9 February 2024 - 8:56 am
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Thank you all for your advice!

It has really helped ease some of my anxieties. I will try to answer all your questions. I apologize for the length!

His name is Gryffin (short for Gryffindor, because he kind of looks like a lion). I have uploaded his picture to my thumbnail.

Gryffin was a fairly active dog until January 22ish. He loved his walks and playing with his dog friends and cats.

We started the Liberia in December because his vet had said that would be the most effective to help his arthritis. He has had 3 doses so far and I’ve never seen any improvement while he’s been on that. He was prescribed meloxicam from his former vet in January 2023 (we loved her but she left in November and is no longer continuing being a vet). Since the flair up he had in January 2023 was his first, this vet wanted us to use the meloxicam as a spot treatment, meaning he would only take it if he was having a flair up. Gryffin didn’t have any issues with his arthritis again until December 2023. In November 2023, his file was given to another vet, who we are having issues with. I would have preferred to start the meloxicam immediately since it worked wonders the first time he took it, but his new vet insisted that Liberia would help immensely and more quickly than meloxicam.

The prednisone was stopped on January 10th, and I had an appointment with his vet on January 22nd, where we put him back on meloxicam since I did not see any improvements with the Liberia. This is when things started going downhill quickly in terms of his mobility. He was walking better three days into the meloxicam, but then he suddenly started having issues using his back leg.

I love him, but he’s a bit of a dummy, so it’s completely possible that he sprained or twisted his leg. We live in Quebec and he used to love diving into the deep snow. Despite my best efforts to stop him from going in the deep snow, where he has more difficulties walking, that’s where he wants to go. I’ve explained this to his vet, and during his appointment with her, he was already experiencing some lameness. She did not seem to check his legs or evaluate his other legs at all. She simply says that he needs to lose the weight to help his mobility and that he needed to be on meloxicam, Liberia, and Cartrophen because he “needs all the help he can get”. I spoke with her yesterday and she said it was unlikely he would regain mobility in his back leg, and I would need to start thinking about making “the decision”. I asked her if it is possible that it could be an injury and she that it’s possible, but said that the meloxicam, Liberia, and Cartrophen is his best option. He has been on meloxicam since the January 22nd, Liberia since December 8th, and Cartrophen since February 5th (I fully recognize that I need to give the Cartrophen more time to work since he still needs 3 more injections until we see the effects of it). I am just extremely worried because his mobility as significantly decreased since the stop of the prednisone and the start of the meloxicam. I fear that I am overmedicating him with medications that are not suited for his case.

Gryffin is still a very happy dog, and he doesn’t seem uncomfortable or in pain. He is able to go to the bathroom on his own outside despite not being able to lift up his back end as much as he would like to. He lifts his back end up enough to go pee and poop without his touch his fur. I have been using the belly sling that I was given at the time of his amputation to help him get up and walk around, but it seems like that irritates him since he’s been fighting against me more and more (he weighs 140lbs. I weigh 140lbs and am only 5ft tall. It’s been a struggle…)

I am fully prepared to continue helping him walk as long as he doesn’t seem like he’s in pain. I just feel like this vet has written him off already. This vet also told me that no vet would amputate his leg because she thought he wouldn’t do well as an amputee, and  he had been doing amazingly until these past few weeks.

I really appreciate all your suggestions and it makes me feel more hopeful and when I have spoken to my vet. I will definitely look into seeing if there is Rehabilitation specialist/physical therapist for dogs in my area. Like I said, I live in rural Quebec, so there are not as many services here as I would like, especially English services!

The Rainbow Bridge



Member Since:
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9 February 2024 - 11:38 am
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Kiersten, thanks for that background info. Yes, walking in deep snow is HARD WORK. But that shouldn't be the cause of what's going on.

I read all the way through and gasped when your vet suggested euthanasia without looking into other diagnostics.

Trust your gut feeling. Get another vet opinion asap.

We see things like this happen sometimes and usually it's a matter of finding the right therapy and pain control for the situation. Sure, there are some cases where euthanasia is the only way out of the pain, but in a dog who was doing so well and then went down like this, it deserves more of a look if you have the ability to cover the costs of diagnostics (an MRI may be required and they aren't inexpensive).

Here is a list of rehab / physios in Canada. The gold standard is a vet who is also CCRP certified I see some in Quebec but not knowing exactly where you are I'm not sure how close they are to you:

https://www.ncs.....rp-canada/

If you cannot locate one please let me know, I'll ask around.

There are also excellent AAHA-accredited vet practices in Quebec. I can help narrow down the options if you want to message me your closest city:

https://www.aah.....locator/ 

The Rainbow Bridge



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25 April 2007
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9 February 2024 - 1:03 pm
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Interesting, but did your vet mention anything about the risk of corticosteroids on arthritic joints?

I just came across a quote from one of our favorite orthopedic vet experts, Dr. Denis Marcelin-Little, who says in reference to Tripawds with osteoarthritis: "Some medication promotes like corticosteroids which should be avoided because they are fairly detrimental to arthritic joints."  So a couple of studies that mention this risk are here and here if you want to check them out.

I'm not a vet. But this quote reminded me of your situation. It's been over a month since your handsome boy (love the pic!) has been off pred so I could just be shooting in the dark, but thought I'd bring it up.

Virginia







Member Since:
22 February 2013
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9 February 2024 - 9:31 pm
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Just a quick pop in question.  Is your sweet boy on Carprofen and meloxicam at the same time??

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



Member Since:
25 April 2007
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10 February 2024 - 8:56 pm
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benny55 said
Just a quick pop in question.  Is your sweet boy on Carprofen and meloxicam at the same time??

  

That's what I've been wondering. I can't recall ever seeing them given simultaneously.


Member Since:
8 February 2024
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12 February 2024 - 7:46 am
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Hi,

Yes, the vet highly recommended that he take both Meloxicam, we started that on January 22, and Cartrophen injections, which we started on Feb. 5th. He hasn’t had his full induction of Cartrophen yet, meaning 1 inject every week for 4 weeks, then once a month.

The vet who took over his file (who we saw in January), never suggested any x-rays or MRIs to see if something more was going on. Since this vet is new to the vet clinic, I am debating between asking for a second opinion from a different vet there or having his file transfer to a different vet clinic that is 30 minutes away. The other vet clinic has does have vets who focus on rehabilitation, though not CCRP certified (Thank you so much for the list. The closest CCRP vet is 2 hours away from me).

I didn’t know about the cortisone effecting arthritic joints. He’s had 3 vets involved in the prednisone prescription, so I am very disappointment none of them would have mentioned that.

Thank you again for all the information you have provided me.

The Rainbow Bridge



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25 April 2007
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12 February 2024 - 10:22 am
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Ah OK. I found some good info on Cartrophen from a veterinary site:

Cartrophen
Cartrophen is an injection that helps arthritis.  Cartrophen is not cortisone and it is not carprofen (a pain relief medicine).  It is a disease modifying osteoarthritic drug and is the only drug in the class (some copycat drugs have come out e.g. Pentosan and Sylvet but they are not as good). 

It is most beneficial when given by injection once a week for 4 weeks.  It is very effective in joint problems.  It increases the enzymes in the synovial fluid in the joint.  This helps the cartilage to heal. 

Cartrophen can be used at the same time as pain relief meds e.g. Rimadyl, Metacam or cortisone.  It works best when combined with glucosamines and chondroitin. E.g. Seaflex, Arthrocart. It can also be used with omega 3 oil supplement.

I think we were all thinking you meant Carprophen (Rimadyl), so now I get it. And I see why they are giving both medications.

But it does sound like some additional diagnostics are needed as this isn't working. I would not get that opinion from the same clinic even if it's from a different vet. If you have a specialty clinic nearby, now is the time to get her file transferred for a second option (instructions for doing that are here). Sometimes that can make all the difference for a dog, and can even be lifesaving as we've seen here.  

Regarding the cortisone. From what I read there is a risk, not a certainty, that it could negatively impact arthritic joints. It won't happen in every dog and sometimes the benefit outweighs the risk if immediate pain relief and inflammation reduction is the goal. I wouldn't be too quick to be upset about it, but it's just now part of the puzzle of what's going on and should be considered I think. Again, I'm not a vet, so FWIW.

About rehab practitioners: If you'd like to PM me your city I can try doing a more extensive search with other databases. I'm often able to find closer therapists than most people think are available. Can't guarantee it but I'm happy to try.

Virginia







Member Since:
22 February 2013
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12 February 2024 - 3:59 pm
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Jerry, thanks for clarifying  it os NOT Carprofen....Phew!

Just to add my FWIW 2 cents on the cortisone .  Ditto Jerry on cortisone injection.   It may...or may not...cause additional breakdown.  I had a very senior dog who had several injections (steroid/cortisone))  that did  indeed  helped with no noticeable side effects.   .  I also personally have had several knee injections for bone on bone that also helped tremendously.  That said, there is a point  where they are no longer effective.I've  used Prednisone pills off and on through the years for various dog alments .  For me, I always found the benefits outweighed   any potential side effects

Curious,  what was the dose of Pred he was on and how long was he on it??

Also ditto Jerry on another opinion.  A fresh pair of eyes always helps.

You are doing such a superb job of caring for Gryffin👏💖

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!

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