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Neb's liver and arthritis #355252
05/08/21 10:11 PM
05/08/21 10:11 PM
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Toronto, ON
jarn Online content OP
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So - Neb has arthritis. We realized this and started him on cartrophen (not caprofen or whatever it's called) which is supposed to rebuild cartilege. We gave him his shot weekly for a month (at which point he would've moved to monthly) and there was no improvement in his stiffness.

He had his annual during that and they agreed he has spinal arthritis.

So, we contacted them at the start of the week to say 'We need to think about pain management'. In their opinion, the options were NSAIDs, gabapentin (which is a nerve pain med so it's not my first choice), and tramadol (kinda opiate-y for a 13 year old dog? I don't know I want him on it long-term, and I am hoping he'll be around long-term).

He hadn't had bloodwork (beyond heartworm) since late 2019, so Toby took him yesterday for kidney and liver.

Kidney is great.

Liver - ALT is elevated (not horrifically, but enough that he can't just start a NSAID). They said we could try gabapentin or tramadol, but that in the vet's opinion, NSAIDs would be the first choice.

They had to order it in, but we are going to give him milk thistle for 3-4 weeks then retest. It's supposed to be liver supportive. I would expect that if it helps he'll have to stay on it while he's on the NSAID? But I didn't think to ask.

They think the ALT is likely just age-related changes. I know he's had issues with vomiting bile (GI upsets can also affect ALT) but that's almost stopped lately. So I doubt that. He did throw up this morning, but that's AFTER the test.

So, sigh. Never rains it pours.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355254
05/09/21 05:22 AM
05/09/21 05:22 AM
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middleofnowhere Offline
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For arthritis, lazier (sp) treatments help a lot, so does chiropractic adjustment paired with acupuncture. That's been the deal with my dogs. Don't have anything to offer on liver support.

Re: Neb's liver and arthritis [Re: jarn] #355256
05/09/21 12:02 PM
05/09/21 12:02 PM
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Toronto, ON
jarn Online content OP
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We've done chiro with Neb (and Luc) before - I'm a bit worried his arthritis is too bad for adjustments - Timothy's elbow arthritis is. I suppose we'd have to x-rays, but we're living on a tight budget at the moment. Something worth saving up for. I'll ask about laser when we pick up the milk thistle next week.

For whatever reason, our vets do not seem to be enthralled with laser therapy - at least, when I asked about it for Timothy they were meh. At least, the injections worked with him. He's rebuilt cartilege I guess.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355260
05/09/21 04:37 PM
05/09/21 04:37 PM
Joined: Feb 2010
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Toronto, ON
jarn Online content OP
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I found a vet nearby that does laser therapy. I'll talk to them and see if they need to see records from our vet (who I am pretty sure does not do it).


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355261
05/09/21 05:31 PM
05/09/21 05:31 PM
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Mary Jane Offline
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I wish I knew something helpful-but I do have a small concern: opiates are really not for everybody. When Nova had a minimally invasive spay (another story), she was supposed to take tramadol for some days. She couldn't tolerate it-within hours the little girl couldn't walk in the house with the e-collar on-food was an enemy. I hope you have alternatives for Neb-especially for the long-term.

MJ

Re: Neb's liver and arthritis [Re: jarn] #355263
05/09/21 05:44 PM
05/09/21 05:44 PM
Joined: Feb 2010
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Toronto, ON
jarn Online content OP
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Thanks MJ. We tried Luc on tramadol at some point in the last few months of his life. He also couldn't tolerate it. He went off it close to immediately. That experience is definitely colouring my perceptions of it.

That, and Nebbers is only 13 - we hope he'll be around for years yet, and I don't want him on an opiate long term, at all.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355264
05/11/21 03:59 PM
05/11/21 03:59 PM
Joined: Dec 2011
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Tennessee
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I haven't shared what has been happening with Abbey simply because there was too much going on. But concerning pain mgmt, I thought to share our experience in the last couple of months. I will keep it short. Abbey was on Tramadol from November to March-ish. Only reason she was taken off of it is because it did not help with pain mgmt and she messed up her leg from her obsessing over it. Her blood work last done a couple weeks ago and done in late March showed her organs are functioning fine. Prozac and... Some other medicine I cannot remember were awful on Abbey. She has been on gabapentin since I think November and has been on deramaxx for a few years. Cannot remember the name of it, something like Anypril dang, its $100 for a 30 days supply. Her current diagnosis is *something* neropathy, spinal arthritis, hip dysplasia, and severe arthritis in her right rear paw. She has lost feeling in her right hind leg and her left hind leg is showing signs of similar loss of feeling as well. She turns 13 next month.

The nerve pain mgmt, pain blockers, and the mental nerve disorder mgmt all seem to be helping Abbey. She isn't muzzled nearly as often to prevent her from mutilating herself. She is wagging her tail again.


Abbey: 12 years old German Shepherd

Suki: 12 years old grumpy Calico

Bella: Ragdoll. Now living with her best cat friend Ty at an oversized cat condo in Crazy Cat Lady City.

2 little angels/monsters in disguise: My 2 boys
Re: Neb's liver and arthritis [Re: jarn] #355265
05/11/21 07:13 PM
05/11/21 07:13 PM
Joined: Feb 2010
Posts: 882
Toronto, ON
jarn Online content OP
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jarn  Online Content OP
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Thanks DE. It's good to know gabapentin is helping Abbey. I'm not familiar with deramaxx, will look into it. Luc had similar issues at the end, though his hips were fine (he had arthritis and a polyneuropathy; no matter what/what kind of pain med we tried, nothing helped). I suppose seeing Luc struggle colours my perception of poor Nebbers.

Neb's milk thistle has come in, but I slipped (darn wet grass on a hill!) this morning with the dogs (Agis was fixing to poop after a VERY long time outside, and he pulls right before he poops) and compressed some vertabrae in my neck, my ulnar nerve is causing issues. I drove to the chiro but had trouble turning and looking so I'd rather not drive anymore today. Man but I'm not 'old' yet, but my poor aching body!

I'm so glad Abbey is doing better! That makes me really happy. And wagging her tail, yay!

Neb still has his moments. I was eating half a (small) honeydew melon this morning and "accidentally dropping" small bits for Nebbers (I do that for him sometimes because he's old and deserves it). Was heating my back (turns out ice is better at the moment) and put the melon on the chest of drawers in our entry way as one of our (formerly fat and still has the appetite) cats will go up onto the dining table and eat any sort of food, even if it's not food you'd think a cat would like.

Well - who stood up and grabbed a piece of melon from the bowl but Nebbers (I took it away). Give them an inch, eh.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355266
05/11/21 09:40 PM
05/11/21 09:40 PM
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Posts: 2,908
SeanRescueMom Offline
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Sorry about your neck, Jenn. Regarding the laser therapy that middle mentioned, our vet had recommended it for our cat who has arthritis in his back end. She said it's important who you go to for it but she's seen excellent results so you may want to look into it. I hope the milk thistle helps Neb too. crossedfingers


Sean - 1998/2014
If there ever comes a day when we can't be together, keep me in your heart I'll stay there forever.
Carleton DOB unknown
Neely - 2003/2015
Gizmo -2008/2011
Neeko -1991/2005
Re: Neb's liver and arthritis [Re: jarn] #355267
05/11/21 11:47 PM
05/11/21 11:47 PM
Joined: Feb 2010
Posts: 882
Toronto, ON
jarn Online content OP
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jarn  Online Content OP
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Leaving aside that Toby doesn't feel laser therapy has proven efficacy in a double-blind study or what have you, all of the places here that do it aren't taking new patients (neither is our vet) - yay COVID!

So milk thistle it is.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355268
05/11/21 11:48 PM
05/11/21 11:48 PM
Joined: Feb 2010
Posts: 882
Toronto, ON
jarn Online content OP
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(and thanks about my neck)


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355269
05/12/21 07:05 PM
05/12/21 07:05 PM
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Posts: 3,233
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middleofnowhere Offline
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For the last duo when I lived in Arkansas, the best for pain management really was a chiropractor who primarily treated humans. He was the heck and gone magic for my aging dogs. Other adjusters help, in particular a vet in Arkansas, but that man was, well, magic. Or at least very very very good.

Re: Neb's liver and arthritis [Re: jarn] #355270
05/12/21 11:12 PM
05/12/21 11:12 PM
Joined: Feb 2010
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Toronto, ON
jarn Online content OP
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jarn  Online Content OP
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We've taken Neb to the chiro before, when he had an SI joint and sacrum out of joint. It costs $120/visit here though, and while I hate to put a price on that, we don't have that kind of cash to be doing weekly visits of $120. We did Luc when he was middle aged and had mild arthritis, and never particularly noticed much help.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355271
05/14/21 11:51 AM
05/14/21 11:51 AM
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Toronto, ON
jarn Online content OP
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Toby got Neb's milk thistle yesterday - it's $68 for a 6 week supply - which is way more doable. Whew. So I hope it helps and he can go on a pain med.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355272
05/14/21 09:57 PM
05/14/21 09:57 PM
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SeanRescueMom Offline
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Thanks for the update -I'm glad Toby got the milk thistle. Do you know how long it takes to show any signs of improvement for Neb? Please let us know if it helps.

Last edited by SeanRescueMom; 05/14/21 09:58 PM.

Sean - 1998/2014
If there ever comes a day when we can't be together, keep me in your heart I'll stay there forever.
Carleton DOB unknown
Neely - 2003/2015
Gizmo -2008/2011
Neeko -1991/2005
Re: Neb's liver and arthritis [Re: jarn] #355273
05/15/21 12:17 PM
05/15/21 12:17 PM
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Toronto, ON
jarn Online content OP
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Thanks SRM. I'm not sure as I didn't notice Neb showing any signs of being unwell from the liver - just old age/arthritis we noticed. Bloodwork is scheduled for four weeks from now so I'm guessing by then we'll know if it's doing anything. Will update for sure.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355283
05/16/21 05:41 PM
05/16/21 05:41 PM
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Shilohsmom Offline
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Jenn, how's your neck and how's Neb doing? It's so hard with everything being so expensive. I was lucky. I was able to cash in some of my life insurance in order to pay Eli's pain meds which were over $500 a month. I don't know what I'd do now if I had bills like that.


Rosa

Proud Mom to Kody and Sasha
and never to be forgotten, Shiloh, Shoshi and Eli
Every dog deserves to have a human that thinks its the greatest dog that ever lived!
Re: Neb's liver and arthritis [Re: jarn] #355285
05/16/21 08:53 PM
05/16/21 08:53 PM
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Toronto, ON
jarn Online content OP
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Thanks Rosa. Neck all back to normal.

Neb's okay - holding about the same. Toby took him yesterday to the park across the street, so he could slowly wander around off-leash. He brought his favourite leather rag to tug with and Neb was half-hearted, especially with shaking his head and 'killing' the rag. So he does have discomfort.

Yes, we don't have any other sources of income than what we do currently. Though Toby's going to be working 5 days a week again (for now) so that should help some. And I'm thinking chiro would supplement, not replace, pain meds, so we need to be prepared for both costs.

We have insurance on the three youngest - last year I looked a bunch of places to see if they would insure Neb, and none of them would due to his age.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
Re: Neb's liver and arthritis [Re: jarn] #355290
05/17/21 04:40 PM
05/17/21 04:40 PM
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Shilohsmom Offline
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Glad to hear your neck is better happyboogie

Too bad no one would insure Neb. Glad he was able to get out and enjoy some time in the park with his favorite toy. All we can do is the best we can do. Your doing a great job with your fur family. hugging


Rosa

Proud Mom to Kody and Sasha
and never to be forgotten, Shiloh, Shoshi and Eli
Every dog deserves to have a human that thinks its the greatest dog that ever lived!
Re: Neb's liver and arthritis [Re: jarn] #355295
05/17/21 07:20 PM
05/17/21 07:20 PM
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jarn Online content OP
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Thanks Rosa.

An intriguing development. A week or two ago, when his liver values came back elevated, I asked the vet if him getting pepcid (which he gets twice a day for vomiting bile - he also gets fed 4x/day now) could affect it. She looked and said no evidence. I called today to see if there was anything else we could do for him before he gets the retest of ALT.

She called me back and said 'I was going to call you today. I poked around and found that while there's no evidence that pepcid raises ALT in dogs, it has been shown to do so in humans.'

Hmmm...not a definite causal link but enough that we're going to slowly transition him off of pepcid and see how he does. We'll keep him on the milk thistle as well and retest June 11th as planned.

And I pick up gabapentin today to help with pain until the retest.


Jenn
Neb, Xerxes, and Agis
Timothy and Cordelia (kitties)
RIP Luc
RIP Teagan
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