Pain Meds for Dogs and Managing Your Dog’s Comfort for a Lifetime

175 Comments

1. Angela more concerning for me than her weight right now is how you are going to protect her from not injuring her other hind leg. Statistically 50% of dogs who tear one ACL go on to tear the other hind leg ACL within a 1-2 year period of time from the first surgery. Make sure you watch the video I did on evaluating the hind leg muscle…you can find this at https://www.topdoghealth.com/rehabcenter. As for the weight increase you did that right thing by decreasing her total caloric intake…it is just a matter of time as you increase her exercise that she will stabilize and find that best weight again.

2. Angela evaluating pain is difficult even for some experienced veterinarians. The best advice I can give you is this. If you don’t notice any differences (ie. more depressed or limping more) when she is on or off the medications then you are probably right in your assessment. Your biggest challenge though is going to be controlling her and keeping her from hurting herself. You have to remember that primary bone healing takes a minimum of 8 weeks and this is critical for her long term recovery so stay as conservative as you can with her. Good luck.

3. Brian the dosage of Tramadol is 1mg/lb therefore for a 95lb patent of mine, I would start them at 2 (50mg) tabs three times a day. That said in some rare cases there are dogs who are “sensitive” to this drug and experience a sedative effect and in those cases I simply lower the dose.

4. Linda this all seems very strange to me. The first strange thing you mentioned is the maggots. Where are they and why are they there? Without being able to see her and touch her I am very limited in the advice that I can give you. That said if this was a disc issue then yes technically the prednisone at the right dosage should have helped more than the medicam alone….but I am in-line with your thinking. I like to stick with what works and if the Medicam improved her quality of life more then I would have a tendency to go back to that. I can’t help by think there is something stranger going on here and it may not hurt to simply get a second opinion from another veterinarian in the area. I wish there was more I could do. I wish you guys the best and tell me how things go. Dr.J

5. Linda, I assume that your veterinarian had the removed tissue biopsied. If this was a lymphoma which from the sounds of it probably is, you should know that there are a ton of simply chemotherapy protocols that can be very effective in helping treat and manage this…and believe it or not the cost of doing some of these is not crazy expensive. In my practice we use Idexx laboratories and when we run a biopsy we have access to discussing the case with a veterinary oncologist. For many of my lymphoma dogs I have been doing single agent therapy with doxorubricin and have had great results. I would discuss whether this is an option with your veterinarian. I am sorry that your girl is sick with this cancer. My own dog is battling cancer right now and I know how emotionally difficult it is.

6. Also a little more info… the Siberian Husky is 4 1/2 yrs old. She is 76lbs (a little overweight). I had her down to 70 lbs before the injury by a prescription saeity diet (prescribed by the vet) and walking 3 to 5 miles a day. She was doing well. Now its not exercise at all.

   Her complete CCL tear occurred when I made the mistake of letting her run amuck at the dog park because she loves to play. Her CCL was already injured (just not completely ruptured) previously but she was doing so well on the walks I made the mistake of letting her do more with the running and cutting she loves at the park.

   As for the pain issue she always wants to play so she doesn’t appear to be in much pain.

   I’ve bought her sqweeky balls, toys and give her the occasional raw hide to help keep her entertained and distracted other wise she talks up a storm. She’s such a clown.

   My other concern is how easy she gains weight from the inactivity. I’ve even cut her dry kibble back to 2 cups a day and give her a small amount of protein (like chicken heated with just water just for taste) She is stubborn without it and will refuse to eat for days if I don’t.

   Any dietary suggestions to help with the weight control? I’m pretty sure they’ve already checked her thyroid and the labs were within normal range.

7. Dr. St. Clair
   My Siberian Husky had a TTA 3 1/2 weeks ago. She is extremely energetic and I’ve been able to keep her contained in a small room. The first two weeks I medicated her twice a day with Rimadyl and Tramadol as the vet recommended along with starting a prescription joint supplement. She appears to be her spunky self and I’ve stopped the pain meds but continue with the joint supplement. Is this too soon. I’m afraid the more I medicate her the more she will try to do too soon.
   She doesn’t appear to be in very much pain. What is your opinion? Not sure what to do.

8. Great idea. Thanks! I noticed a change in the way my dog holds her ears when she is uncomfortable or in pain (she puts one ear down).

   What dosage of Tramadol should a 95 lb. GSD be given? 50 mg. seems like a lot.

9. My almost 14 years young Golden has always been healthy, except for hip arthritis after longish hikes. (She’d not be able to go up stairs until I rubbed her really hard, and then she’d jump up good to go.) My daughter has been taking good care of her in California while I spend winters in Mexico. On Dec. 29, my daughter suspected a UTI, but the vet said the UA was negative. She rec’d an ultrasound suspecting a mass, but no mass was found. Hannah had a back right leg limp and inflammation in her private parts and strange lesions on her exterior vulva. Vet rec’d a try of antibiotics (7 days) during which Hannah went downhill fast…stopped wagging, stopped getting up w/o help, stopped being ‘happy’.Started on Medicam on Jan 17 and it was like ‘night and day’: happy, walking well, slept all night, less groaning when pooping. YES! But she had an appt with the vet who consulted w/ a specialist in giving her a neuro exam on Jan 26.Vet decided she had neuro issues and 50/50 herniated disk OR tumor. Wanted to switch her to Predisone after an 8 day cleanse of NSAID. and Gabepentin and tramadol for nerve pain. Hannah started going downhill immediately off of the Medicam: Lost ability to sit, to stand up; he foot knuckled under when she walked. She started Prednisone Feb 4 (10ml 2 x day) and continued to go downhill. became incontinent Then developed a rash, then sores on her leg, her abdomen and under her tail. My daughter even saw some maggots. Vet finally returned call today (5 days after calling her) and said: if Prednisone didn’t help, it must be a fast growing cancer. So my question is: if it is cancer, why did the Medicam make such a night/day difference in her symptoms (within 8 hours) while the Prednisone did nothing? (I have to be honest and say that I was against changing a drug that was working to a new one from the start.) And since the Medicam does offer some pain relief in addition to anti inflam, I’d like to stop (wean) her off the Prednisone (11 days on) and get her back on Medicam. I don’t expect a miracle (well, I can hope for one) but at least Hannah seemed happy while on this drug just two weeks ago. And maybe Hannah responds better to Cox 2 inhibitors than to other pain meds. My second question is: can it hurt her? WE decided not to do Xrays or chemo or surgery due to advanced age and cost (Xrays/MRI $2500!!!) I’m living on social security income. Thanks for your thoughts!

10. Our 10 year old female German Shepard is in a lot of pain from breast cancer in lymph nodes in her arm pit. In november, we had one hard lump removed that was a lymph node and 30 days after removal, another lump has appears which is causing her a lot of lameness and pain. She is on rimadyl 75 mg twice a day and tremadol 50 mg 4 times a day. Are there other medications that you would recommend or different dosages? We appreciate any advice you can give us. She is under good vet care, but this is a small town and I tried to consult with a onocologist at wsu, only to be told by the receptionist that I couldn’t talk to the vet without having him look at her. A 4 hour ride in the car would be horrible for her. Thank you for your help!

11. Gary this is a great question. I will agree with your doctor in that I am not a big fan of long term use with aspirin solely because of it broad mechanism of action. Medications like Deramaxx are much more target and specific in there effects to blocking bad inflammation and not blocking all of the good things. That said, branded NSAIDs like Deramaxx are expensive for sure yet you can discuss with your veterinarian the potential of using generic carprofen. This drug was originally created by Pfizer and called Rimadyl. It is not off patent and there are several generics available at more than half the cost of Deramaxx. In addition you can also potentially add generic tramadol for a more comprehensive approach to your dogs pain management. Hope this helps, Dr.J

12. Venkatesh, thanks for the email and sorry for the delay. To answer you question we absolutely ship our products all over the world. That said, the only limitation is on shipping cost but we can get it don’t. Hope your dog is well.

13. Hello – I have read you info as well as others and have a simple question. I have an 11 year old yellow lab (about 100 lbs) who has been having issues getting up and on stairs etc – last fall my vet offered Deramaxx 1x a day 75 mg – this seemed to be great for him. The issue is the cost – is there a more affordable alternative with the same results? I have read info on Glucosamine and buffered aspirin but get conflicting info. My vet was not a fan of the aspirin as they noted issues with a dog who is on it for a long time. Any thoughts?? Your input would be appreciated.

14. Is there a possibility of making available TopDog’s supplements in India.
    Amazon.com does not ship them to Inida, as I could see.

15. Siobhan that is great that you told action with the diet and hydrotherapy and saw results with that. My question is whether or not you continued on with the hydrotherapy. When it comes to chronic arthritis management it is a powerful thing to do but you need to continue with it. That said I also see that you did not mention whether or not you had him on a high quality joint supplement that has proven ingredients to promote optimal joint health. This is a very important component in overall holistic joint health. As for the other medications, it may be that you need to use a different anti-inflammatory (other than metacam). Often you need to find the right anti-inflammatory for your dog. As for tramadol this also can be played with in terms of dosing. Just make sure you discuss with your veterinarian that you are well rounded in your total approach.

16. Darrin so sorry that I totally missed this post from you. I am sure by now that you have this figured out. That said just to answer your question there are several other options for opiods on the market for pain management….it just so happens that tramadol is affordable and relatively effective so it is widely used in the veterinary community. To this day the only side effect I have had reported to me was excessive sedation in dogs ultra sensitive to the medication and in those case if we reduce the dose the dogs seem to do fine.

17. Hi I have a flatcoat Robbie who is 8 years old. Last year he started limping a bit so I took him to the vets. The X-rays showed arthritis in his elbow. I started him on a new diet & hydrotherapy. He stopped limping till 2 weeks ago when it came back & was really bad. I started the metacalm meds again but they didn’t work so the vet started him on tramadol today. What I forgot to ask him though is when I should start seeing it work for him?

18. Hi, Love all the info you provide and have been following your weekly guidelines after TPLO surgery. We have female lab, has taken rimadyl for awhile but had some type of reaction to tramadol (fast heart beat) Is there another drug like tramadol that may help her?

19. Judy this sounds very very very rare for a 2 yr old to be going through this kind of problem. Have you seen a neologist or had a spinal tap done?

20. Joey that fact that he struggles to get up tells me he is in pain and that should be one big focus for you. No doubt it is very stressful to see them struggling and it makes me so sad. I recently lost my dear friend of 13 years and it was painful to watch him have these difficulties. The pepcid is great and may help but pain control would be my next focus.

21. Marie you have to rely first on what nature tell us WORKS when it comes to joint health. There are a handful or really high quality natural supplements on the market with ingredient into improve and condition optimal joint health, GlycanAID HA being one of them. In addition you can maximize your omega 3 content and also there are herbal combinations proven to help with uncomfortable joints. Remember there are always many options in life, you just need to find the path that works best for both you and your dog.

22. Pamela for me the key is maximizing all the natural alternatives first. It still ceases to amaze me how effective these natural alternatives are. Once you have maximized these then I look toward pharmaceutical options (ie. safe NSIADs and then eventually the addition of opiod pain medications like tramadol). I have a really good info graphic that details all of this here. https://topdoghealth.com/blog/pain-meds-for-dogs-and-managing-your-dogs-comfort-for-a-lifetime-113/
    If we can provide any more value to you please tell me and we will do anything we can to help.

23. Laura this is a very sad situation. From the sound of it the best surgery option would be to have an FHO. This would preserve the limb (i.e..no amputation). The recovery would take some time but the end result would be positive. I wish there was more that I could so for him and your and your daughter. I assume that at this point he is on 3 legs and not using that leg at all.

24. Hi again, just wanted to post that this did end up being an ACL (ccl) tear and a torn menicus so I urge anyone reading this blog to be sure to visit a vet, we had no idea how bad the situation was. Our dog underwent surgery last week and is slowly recovering – it’s a 12 week no activity recovery. :(

25. My 2 yr old pointer has been diagnosed with diffuse idiopathic skeletal hyperostosis and spondylosis. He is on 300mg of gabapentin 2x a day, but is still having some trouble going up stairs. He was on previcox too, but we stopped it to see what would happen. I’m thinking about upping the gabapentin to 3x a day, adding the previcox back in and dasaquin too; and possibly tramadol?? He is so young, don’t want him to be in pain, but it seems like so much medication!?! Any suggestions?

26. I have a 12yr old lab. Within the past week, he has been just lying around, not eating his dog food. He still drinks penty of water, and will eat some foods like hamburger, chicken, lunch meat, hot dogs, edamame. We took him to the vet and, and they wanted to run about 500.00 in tests, i do not have that. They also gave us the quotes for us to put him down. This all started so fast, i thought it must be something else. We have been now giving him Pepid AC, vet said that he may have an ulcer. He has been on predizone and we have cut that back to 1/2 a pill. I do have some tramadol at home, and wonder if this would help him. He doesn’t seem to be in pain, just more irrataited and frurstrated that he can’t just get up like he has. It takes im a while. I am at a loss..I am not ready to put him down, just hoping there is one more thing out there i can try…

27. Hi,
    i have been looking with zest for a suitable pain relief, for my wonderful sheepdog, as an Oil Painter and often turning to nature for my own health, as i like my wonderful dog have sensitivities,,to the majority of medications .
    I agree, we have very very little understanding of, animals in General, and indeed often in not watching ,as i do my sheep dog,learn , about health, the medications, you mention, i tried one Metacalm, and it was me, that saved my dogs, as there was , such a dreadful side effects,i have tried high omaega, in oils ect the two , oster based tablets , which also were awful , with my dog, she has been eating lots of soil and is seeking a mineral, which may be a help, i will be intersted, in what you say, as i have been a professioanl Artist, and learn to paint every day, my DR Pals, learn every day, HOW, can a human even reach the instinctual level, of an animal so precious, as a dog, a sheep dog, [mine i saved from death, as a pup , from awful people, i lived rural, and took her, people have brought animals to me, however, i never use anything other than, instinct, as we do not and never will, tap into what our noble animals are trying to teach us
    We, assume very wrongly, what our dogs are hear for, and are indeed, as you and your father say, so tuned into there inner healing , WE, must learn to take time, listen watch, love, send loving calm, caring, as they pick up and can take unwell even in a vets, with fear. I tell my vet what to , do how to do it, as my dog tunes into me, we are doing a proceedure without any sedation this week, as i will not ensue any emotion upset, so i know it will be exactly as my dog has told me, i listen, it is possible to do so , i love your site, and will be asking about this pain relief you say your fav, i want her to have it she is, saying no, as i tune in ,its a question mark, as the asprin, being bark of a tree , she will take a quarter[yes, vets say no] Marie Hart

28. Hi,Dr. St. Clair! Thank you ever so much for your thoughtful and informative views on pain control for dogs. Three of my Rotti/Pit girls are now 8 years old and so we are just seeing some signs of Arthritis (or “Arf-ritis”). Luckily, my Vet is on board with your pain control ” tweaking” methods so my Dogs and I are grateful for this stance on the use of pain medication! It has made a huge difference already and we remain open to new and improved methods of pain management. Thank you so much for your progressive attitude on this subject..it means the World to Dogs and their guardians!!:))

29. This year my 16 year old daughter lost her best friend of 11 years to cancer, he was a very special lab/rot mix. Honestly I thought she could never replace him but she came across a dog very similar to him, I swear her lab told him how to steal her heart and he did. Our problem is that we took care of the flea’s, ticks, and showed him he didn’t have to be hungry, but he was hit by a car when he was 3 months old, was never taken in. His hip was displaced, at one year now the hip cannot be set back in place due to grinding. We put him on pain pills, but more than we can afford every month, since he came off them he came off his meds he’s become aggressive again, he nearly took my dogs ear off last night. Our options are, full time pain meds, hip replacement, or amputation later. I’m a single mom just trying to supplement my income from disability from post office. After 15 years of hard graveyard shift I was sent out on disability retirement. Now, instead of $41,000 a year I get $16,000 and have to pay full insurance for my daughter. Dad doesn’t want to be bothered. ?

30. Thanks so very much for your answer, it’s greatly appreciated. She seems to be better the past couple days, hoping that it was just a badly sore muscle. Regardless, if it starts up again we’ll be visiting the vet. If it IS arthritis, would glucosomine help or better to use something prescribed? Thanks again!

31. You need to treat her like an athlete. It takes time for things to heal and dogs are not the best when if comes to resting unless it is forced on them. I always use the analogy….If you were a runner and you twisted your ankle…would you take 800mg of ibuprofen and then go back to running….ANSWER = NO! You would rest and allow your body to heal and then slowing restart exercise slowly. Try this course first.

32. Andrea yes it is possible that this is arthritis but it is also possible that this is a partial ACL tear. It is best to go to your veterinarian and get a diagnosis, of course. If you can not afford this ..then my suggestion would be to rest your dog (i.e.. leash walks only…no running in the backyard) for a good 4-6 weeks and then slowly increase activity level.

33. Gregg my suggestion would be to find another vet with in that SPCA network. Tramadol is a wonderful and safe drug. It is also totally affordable. Yes it is a narcotic but you should be able to get a prescription to a local pharmacy to help your dog with pain control. You really should also, if possible, invest in getting your dog on a really high quality effective joint health supplement like the one we formulated here at topdog called GlycanAid HA. Ingredients like these can go a long way and fill in the gaps in many cases.

34. Doreen, absolutely adding a joint supplement and Sam-e is no problem. Cosequin is a great product that uses good ingredients but honestly when it comes to comprehensive joint health management it is a bit of an “old” product. The only ingredients in Cosequin are glucosamine,chondrotin and manganese. Honestly when if comes promoting optimal joint health even Nutramax the makers of Cosequin have evolved from this supplement. For years now they have had their second generation supplement called Dasuquin. If you have time I would encourage you to also check out TopDog supplement which we developed here called GlycanAid HA. This is an amazing joint supplement which has received hundreds of 5 star reviews from pet owners and really is a well balanced and effective joint health supplement. The best place to read reviews from pet owners is actually over at amazon. Tell me how things go…I would love to help you and your dog in any way possible.

35. Thank you so much for your advice, I am happy to report she got better only few days after I’ve wrote to you and now she is back to her old hyperactive self, like nothing ever happened. Nothing short of a miracle :)! But I’m keeping close eye on her, so if these symptoms ever return I will know exactly what my actions should be. Once again, thank you very much!

36. p.s. – she is not overweight, last vet visit we were told she’s “perfect”.

37. Hello Dr., within the past two weeks our 7 year old lab/pit has started limping on her right back side. This only occurs after we have taken a walk or she has run around the yard (at break neck speed, she’s like a greyhound!). It doesn’t happen immediately but after she gets up from lying down for a 1/2 hour or so she will start limping on that back leg. It seems to be coming from her hip. I have checked her paws to be sure there aren’t foreign objects, etc. Does this sound like arthritis? Would something over the counter be worth trying before we go to the vet? We are low on funds right now unfortunately and would really like to try to help her at home first. Obviously we don’t want her to be in pain and will go to the vet if needed, just wondered if there was something we could try first, as it only happens after exertion then rest. Thanks for any pointers….

38. I have an eleven year old German shepherd with severe arthritis and muscle atrophy. I take her to a clinic at my local SPCA. The veterinarian started her on rimadyl which did great for about six months. She is now at the point where she is having a lot more bad days more frequently than good. The vet put her on gabapentin which did absolutely nothing, although I still give it to her. I have done a ton of research on her condition and heard great things about tramadal. In fact one of the vet techs at the spca gives it to her dog. The only problem is that the vet refuses to prescribe it or any narcotic. I am in a terrible situation. My dog lives in pain and I can’t afford to take her to another vet. This veterinarian at the spca is heartless.

39. I have a 12 year old Great Pyrenees that suffers from hip dysplasia and arthritis in her back legs. She is currently on Rimadyl, tramadol, and Gavapetin for seizures. My vet has recently suggested putting her back on Cosequin. I currently have her on Sam-e to see if this helps with the joint pain. Do you think that putting her back on Cosequin along with the Sam-e is too much or will she be okay?

40. Linda in is situation I have to recommend that you take her back to your veterinarian for an evaluation and bloodwork. The panting can be for several reasons, from pain to anxiety etc. The excessive water consumption can also have several origins for anxiety to kidney problems. I hope all is well and she is ok.

41. Nicki your best bet is to stop the supplement for 3-5 days and then once everything is back to normal restart it and see if the same issues arise. Glucosamine can upset some dogs stomach but because if this we specifically use a vegetarian sourced glucosamine for the USA called Regenasure which seems to be much better tolerated. As for how long it takes to see improvement, out standard answer is to allow 4 weeks but most people report back to us that they see if difference is 10-14 days. Hope this helps and please note that if you do not think GlycanAid is the absolute best supplement for him then give us a call and we can issue you a full refund. Please keep us informed. All the best, Dr.J

42. Heather, using a NSAID with tramadol can be life changing for some of these dogs. That said you can also discuss with your vet about changing the Previcox NSAID to maybe a twice a day anti-inflammatory like Rimadyl (or any of it generics). As for the joint supplement we use a vegetarian sources glucosamine in our product called Regenasure which seems to be well tolerated by sensitive dogs. We also a 100% guarantee on this product where if you don’t believe it is the absolute best for your dog simply return if for a full refund. At the end of the day it is all about what I call “tweaking” …i.e. you need to find the right combination that works for her. Sometimes it takes a bit of adjusting to find the right combination. If I can be of more help please tell me. Dr.J

43. Patsy, the answer is yes there are options. The first thing I would do is make sure you have him on a really good joint supplement along with the Previcox. I of course would recommend that you investigate TopDogs product called GlycanAid HA which contains all the essential ingredients to promote optimal joint health. You need a natural foundation first. In terms of other drugs you can always add an opiod to the mix (ie. tramadol) which can be life changing. Discuss this with your vet if you can.
    Hope this helps, Dr.J

44. Beckie, it is no doubt a bummer that he is dealing with this at such a young age. It may be that a surgery like an FHO may be the best option for her. This surgery eliminated the head of the femur, the source of this pain, and these dogs do fantastic long term with this surgery. I have a rehab guide specifically for the recovery if you and your vet choose this path. As for supplements I am unfamiliar with the one you mentioned but I would strongly encourage you to check out the product I developed called GlyanAid HA. It has all the essential ingredients for optimal joint health, it is an amazing formula, and we use amazing ingredients all sources for the USA. This specifically does not have fish oil in the product but we do offer an omega 3 supplement called Flexerna which is a patented oil from the Green Lipped Mussel of New Zealand. I would encourage you if you have time to go over to amazon and simply read the reviews on GlycanAid HA to hear what other pet owners have to say. As for long term NSAID and tramadol therapy…I would personally want to explore all of my options considering that she is only 2.5 yr before I would commit to that course of action. Though I love this drugs and they are hugely beneficial at the right time…she is still young and there are other options to you need to look into.

    All the best, Dr.J

45. Indira since this much of this sounds to be orthopedically related it would be best to ask your veterinarian to take some x-rays for her. You would need images of the spine (thoracic and lumbar), also an image of the hips and then images of the knees. You know the saying a picture is worth a thousand words. This would help you and your vet to then rule out many different causes. I hope that with the pain medication and anti-inflammatories that you are rest her strictly. Also just make sure you are using a glucosamine product that is safe and a good formula.

    All the best, Dr.J

46. Nicki sorry for the delay. I would love to know what your vet said. No doubt there is tons that you can do for his joints both naturally and with pharmaceutical alternatives. I wish that I could help you more with regards to the lumps but please by all means right be back and tell me where you are at. Dr.J

47. I have an Austrialian Shepherd,, 8 years old, she is overweight, couldn’t get her to loose weight, (around 95 lb). She loves to ride in the car with me when I go to the barn, when we got back up to the house she jumped down, didnt yelp but I noticed later that day she wouldn’t walk much, really babied her back leg, I felt around and she didn’t even flinch, so I gave her baby asprins, didnt help. To her to the vet they did X-rays nothing broken, figured it was arthritis. Took a blood test and said her thyroid level was a little low. He gave her Thyrokare 5 mg twice a dat, Tramadol, twice a day(started this 5 days after stopping asprins), Rimadyl twice a day, and Phycox soft chews for joint care….well after being on this , now 3 weeks, she is moving just fine, she wont eat the WD Science Diet Dog food the vet wanted to try her on, and she sets 1 1/2 cups of Taste of the Wild Pacific Salmon, I can tell she last lost wright, but what I am concerned about she pants quite a lot and drinks enormous amounts of water, could this be from the Thyrocare, she didnt do this before.
    Thanks Linda J

48. Hi, I just recently purchased the GlycanAid HA for our Rott/Shepard mix. He is 10 years old and recently started having shaking in his back legs, more so on the right side. My question is, “What if any are the side effects of this medication”? He developed a stomach issue about a week after taking this but I don’t believe this was the cause because he had been taking it for a week. I think it was something he ate. But I thought I would ask just to be on the safe side. Also, I am curious as to how long it takes to begin to see noticeable improvements in his everyday activity? Thanks for your help.

49. Dr. St. Clair,

    Thank you so much for your time. My 14-15yo lab mix has been on Previcox and Reglan (for GI distress from the Previcox) for months. She refuses to eat a glucosamine treat I bought her. She is also on Enalapril and Lasik for cardiomyopathy. I hate that she is on all these meds and the worst part is that her pain isn’t controlled. The vet did try her on tramadol alone but from reading your posts it sounds like she should be tried on both. I would love to try some other things but she is so sensitive to changes in eating now that she gets off her food and won’t eat much if I try to trick her too much. She is a sweet, sweet girl but there has to be a better way to help her.
    I know this isn’t a consult but I would really appreciate any recommendations.

50. My 8yr old dog has been on Previclox for 28 mths now. It was great at first as he showed no sign of pain. has now started to limp again. Can he have other medication along with previclox or will he need to stop taking it and change medication completely . I also give him acidophilus each day as recently his bowel movement is very soft.

51. Hello, I have a 2 & 1/2 yr old pug who has hip dysplasia & has just recently started limping on her rear left leg. I have gotten her weight down, I take her for a walk & swim at the nearby lake almost daily & sometimes she isn’t as active there but is always eager to go. I also have been getting her acupuncture & laser treatments once a week for 3 weeks now & will continue these. I would like to know what is the very best joint supplement that has ALL the important ingredients including fish oil. The vet for our Emmy is a holistic vet that also practices western medicine when necessary. She put Emmy on Benefit Hips and Knees (Chinese herbs) last week but it upsets her tummy causing acid to come up into her mouth so I’m not sure what to do about that. I would like to know how you feel about putting a young dog like Emmy on the Tramadol & rimadyl for her lifetime. It worries me that these drugs will cut her lifetime short. I am so upset about all of this & I just want what’s the very best for my Emmy. Also, why would she have been going along for 2 & 1/4 yrs without limping & now she limps most of the time, especially for a bit after she gets up. We have had her knee looked at on that leg & it’s not the problem so we are assuming it’s her hip. I had X-rays done at UC Davis Vet Hospital & looked at by an orthopedic vet there when Emmy was 1 yr old & the vet said she has hip dysplasia. I hoped that it wouldn’t start causing problems for Emmy, such as limping & limiting her activity, until she got much older but obviously this isn’t the case. I read something about carbohydrate polysulphates working well for some dogs with hip dysplasia, have you heard of this?

52. Dear Dr. St. Clair,
    my vet seems to be no help to my issue and I’ve been searching the internet for days now, trying to find any kind of help to better understand what is going on with my dog. I know it’s a long shot, but I will write this as short and clear as possible, hoping you could at least point me in the right direction.
    My dog is mixed breed (most of it terrier), 4 yr old, about 15kg female.
    She was hyperactive, quicksilver dog up until 14 days ago when I’ve noticed she had problem climbing up and down the stairs and getting up. She doesn’t lay down curled up like before, only stretched. She has normal appetite, her bodily functions are regular. Her blood test came back clear. My vet gave me brown tablets (in a paper bag so I don’t know the name), pain relievers, and I’m giving it to her, half or quarter a day. Also I’m giving her glucosamine tabs. Pain relievers are doing magic and after she has one, she is back to her old self until effect wears out. Also, her barking has changed together with overall physical change.
    I am suspecting a nerve damage or arthritis, but as you wrote, every time we enter vets office, she gets all worked up and seems like the healthiest, happiest dog ever.
    Since my vet is obviously not experienced enough, could you please advise me what kind of tests should i demand to be taken in order to make a proper diagnose?
    I would greatly appreciate any word of advice, the last thing I want is for her to be in pain, but most of all I need to know what is the cause so I can take better care of her.

53. Hello, I love the information that you offer and hope you can help me with our dogs pain management. We adopted a Rott/Shepard mix from a shelter five years ago, Rocky is now 10 years old and was five when we got him. I have always noticed large areas on his back end on top of his back that look like lumps almost but when you pet him it seems to just be his shape, a few days ago I noticed a oval shaped hard feeling on his rib cage while rubbing his belly. Last night while my husband was rubbing him he yelped and has been lethargic today. I noticed that it had more to do with his back legs because after this he didn’t want to walk. I am going to take him to our vet hopefully on Monday, what I am curious about is if arthritis is present what should I place him on to help his joint pain, such as pain management and other supplements to help him live a longer pain free life. This dog is our baby, my children, my husband and myself would be lost and devastated without him! Please, any help would be greatly appreciated. Thank you for the advice and help that you offer, it is truly priceless!

54. Joanne, this is absolutely ok.

55. Is it okay to give my dog Glycan Aid HA while my dog is taking Rimadyl?

56. Hi, I have read this story, and am aware of my dogs issues. We have been trying to manage his pain the bes twe could. He is on Deramaxx (for a few months now) once a day, gabepentin 3x a day (7 dyas now), and I give him Glycanaid-HA. (Been on since April 1). After the 4-6 period, I was giving him the maintenance level, but am now back to doubling up. It seems to make him better. He was ok for two days, then is struggling again. Night time is his worse time, then in the morning he seems 80% better. Still limps but moves pretty good. Tonight walks 5 feet then collapse. Maanaging his pain is difficult. I have to call the doctor and explain this, so I may suggest the Tramedol. It is weird, sometimes I wonder if the humidity make sit worse for him too. Also he is blind so maybe bad balance, or even maybe too much drugs. Confused. He is 14 yrs old too so at that age good and bad days arer expected.

57. Heather I think the first thing to understand is that Deramaxx is ONLY an anti-inflammatory and should not be confused with a true pain medication. You may want to contact your veterinarian and discuss the option of adding in tramadol 1mg/lb to her regime minimum of 3 times a day. This pain medication may be exactly what she needs. I would also encourage you to look into our joint supplement GlycanAid HA. Though the cosequin brand is a good product it may not have everything that her joints need to be comfortable. Hope this helps and I am here if you need me. Dr.J

58. Goldie this is a tough situation because the reality is that you need to know WHERE the pain is coming from. Treating hip pain and treating back pain often are very different. One thing is for sure…she is way to young to be having these kinds of problems. One option would be for you to seek out a state human society that has a veterinary clinic and reach out to them. One option I will mention, though I do this with extreme caution, is you can try her on Bufferin or any over-the-counter anti-inflammatory that is GI coated. You can give this to here for 3 days max with food, rest her strictly and see if she improves. It is not recommended to use these medication past a 3 day period of time because of there potential to cause other Gi problems. My heart goes out to you and commend you on sticking with school and working hard. I honestly wish you the best and hope that she improves and again rest, rest, rest and ice helps immensely with pain and inflammation. Good luck.

59. Yvonne unfortunately I would need more information in order to provide you with any honest guidance. My best advice to you would be to either follow the advice of your existing veterinarian or seek a second opinion with a board certified veterinary dermatologist.

60. Hi Dr. St. Clair, I just spent an hour reading all your posts from the past and it is amazing that you are willing to take the time to help people ease their mind when it comes to the constant worry of trying to do the “right things” for an older pet. Aspen is our 13 yr old Husky. She is 75 pounds and has been on Deramaxx for arthritis (75mg once a night w food) for 1 month. She also takes Cosequin Maximum Strength (3 tablets a day, 1 at breakfast and 2 with dinner). We walk her about .5 mile at least 4x a wk. Since starting the Deramaxx here are changes noticed: she has no hard stool and after taking her crushed pill with dinner, she pants heavily and changes rooms throughout the night pawing at the ground (she used to sleep consistently in her memory foam bed or outside in the cool grass). She is choosing confined corners of room and my dark closet. She is also pooping(not solid) in the house 2 to 3 times a day. When she eats out of her bowl that is elevated off the ground, now her hind legs seem to droop like she can’t hold herself up. Are these side effects considered severe enough to outweigh the pain relief provided? Does the heavy panting mean she is in pain? We started taking it down to 1/2 a pill last night, but my gut is to stop all together…worried about Aspen. If we stop Deramaxx what are some friendly alternatives to keep her arthritis pains down?

61. I love my dog so much and I feel so bad for her that she’s already experiencing hip and back pain. However I live on my own I’m 17 go to school full time and have 2 jobs so I’m working on getting her on pet insurance! I just want something to help her in the meantime! Great articles by the way! Thanks

62. Hey, my dog is still really young she is 1 and a half years old and a golden retriever. She weights 74 pounds. When she turned 1 year I started noticing her limping a lot and that she was in a lot of pain. I then took her to a pet chiropractor and they said they can feel her back is very limited and she wasn’t letting them touch her hips or legs. I don’t have enough money to take her to the vet yet before I get pet insurance however I wanted to know without going to the vet and getting something perscribed what I can try to give her so that she is in a little less pain?

63. Re our 12 yr smooth collie. Had a really bad ear and noseinfection. Got them cleared up. Now the nose infection has come bad. They want to put him on tablets for 45 days I’m really concerned t this any advice

64. I could not agree with you more….and I sincerely apologize for this. It is unacceptable. I lack a good proof reader and focus so much on the content and the message and often leave out the importance of good grammar.

65. That is very kind of you. I try to fit writing into my life as much as I can but at this point I am very limited on time. 4 kids, 1 wife and 3 business…and 100’s of emails to respond to trying to support individuals and their pets. I will be writing more though soon..vacation is coming.

66. Elizabeth…she is in what I call the “tweaking phase” where you need to find the best combination of supplements and medications that continues to maintain her best quality of life and is safe for her body. When it comes to arthritis..I am a fan of tramadol. My standard protocol is this…though please understand that all doctors are different and have their own ways….I like Rimadyl 1mg/lb twice a day…with Tramadol 1 mg/lb minimum twice to four times a day…with our joint supplement GlycanAid HA which has some amazing ingredients and a great formulation. Also note that if one path is not providing the results then discuss it with your vet and switch up the protocol until you find the right one for your dog.

67. You may want to ask about using the Rimadyl twice a day as it was originally designed. The once a day dosing came after a number of once a day products came on the market. Discuss this with your doctor and see what they have to say. The original dosing of Rimadyl is 1mg/lb twice a day….They then said you could increase to 2mg/lb once a day. The most important this is what works best for your dog.

68. Rachel, I am sorry sorry for the delay of this response. I have been away for a while and somehow lost all of these messages from people. I feel sick about it because I have devoted myself to helping all of you. Can you tell me where you are at ..at this point. Just a note..generally it is not recommended to switch from on anti-inflammatory to another without first doing a WASH-OUT period (ie. no anti-inflammatories for at least 3 days.). I will be here moving forward.

69. Mitch…this is so sad. Did you end up putting him down? I just found your message and my heart sank. I am shocked that an anti-inflammatory at such a high dosage did not help him at all. I like to use Rimadyl at 1mg/lb twice a day. Then if needed I will add in Tramadol. This of course is in conjunction with a really solid joint supplement like our GlycanAid HA. Please tell me where you are at so that I provide any help possible. I am so sorry for the delay.

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73. Our 12 1/2 year old lab has been diabetic for 8 months on 18 novolin N twice a day.She has terrible arthritis in her left knee from acl surgery and the typical bad hips. We give her gabapentin 300 twice a day and metCam 70 once a day along with fish oil and hyaluronic acid and glucosomi e. I worry that she may need something stronger. She does get up on her own but appreciates a helping hand. I just want her to be comfortable. Do you think tramadol should be added? Thank you for your advi ce.

74. Thank you. We had a blood test and he was ok to start on Rimadhl (100mg once per day) along with 1 1/2 tablet of Tramadol (two or three times a day), and Dosuquin with MSM.

    And, we started Laser treatment this week too !

    He is back to walking around, some stairs and can get up and down on his own.

75. This is such a great post. We have a lovely goldie/Lab cross who is our baby (literally, we don’t have kids). She is eleven and a half and has bad arthritis through her front joints and now her back legs are going and the vet says it is in her spine, too.

    She had EPI and so we have to be careful what we feed her. She’s been on Metacalm and then Previcox with tramadol on bad days. Sadly, eight weeks ago a blood panel showed raised kidney enzymes and then she got sick. Within a week her liver enzymes had shot up to a very high number. We took her to a special vet hospital where she stayed for fluids and tests. Ultrasounds showed okay liver, pancreas etc. Liver function tests were okay too. Also the EPI had simply cleared up! But she was vomiting and had diarrhea. Vets said it likely to be inflammatory bowel disease or – worst case scenario – a colon based cancer.

    So now she is on Ranitidine for her stomach. And only tramadol for the pain while we struggle to get her stomach under control. Her legs are bad (she can’t do hydro either till stomach calmed down which she’s done weekly, along with physio for nearly a year).

    I am so worried for her. Now her diarrhea has stopped and she went two days with no stools and is only doing small, tiny stools. She is not herself but still eats, still has a couple of gentle walks, wags her tail and has some life to her but not the way she used to be.

    She is also having Cartrophen injections but they haven’t done much. We really need to get her back on the previcox for her arthritis but vet says we may need to try antibiotics for her stomach and if that doesn’t work maybe even steroids.

    Could the constipation be due to the tramadol and not actually due to her bowel disease? Any advice for dealing with multi issues like this?

76. Hi Doctor St. Claire, my name is Mitch, my wife and I have a 15 plus year old black lab mix. His name is Shadow, just last year we noticed him limping on his right front leg. His vet xrayed him and showed us the joint damaged, which he called degenerative joint disease. He started him on 50mg of Rimadyl, with little noticable change he increased it to 150 mg daily for the last three months. We weny back and the vet suggested putting him down. What do you think……Thanks Mitch

77. Donna from the sound of this you need to get a solid diagnosis. What are they saying her problem is…ACL? or a Patella problem? or a hip problem?

78. Jackie I have to admit that I am slightly confused…what kind of surgery are they recommending. When it comes to joint health management the first thing every dog needs is to be on a really good joint supplement. This is the basics of supporting the joint. TopDog of course has created one of the best joint supplements on the market called GlycanAid HA which has received hundreds of 5 star reviews from pet owners. From there it is critical to manage pain…when if comes to joints that usually starts with a non-steriodal anti-inflammatory such as rimadyl and then maybe add in pain medication like tramadol. I think you should discuss this with your veterinarian. The last thing is once the pain is controlled and the joints are being supplied with high quality supplements…then you got to start exercising and start rebuilding that lost muscle.

79. Roy I don’t see this as one or the other….because they are very different things…though we have had many people who use our GlycanAid HA and end up taking their dogs off of the pharmaceutical drugs (ie. NSAIDS like rimadyl) for a period of time…but eventually as the animal ages and their joint health continues to deteriorate all dogs will need both of these together at some point in their future. Even further down the road they will then be on a joint supplement like Dasuquin or GlycanAid HA….and Rimadyl…and a pain medication like tramadol. Yes I think for your dog you should of course continue with the supplements, whether it is Dasuquin or GlycanAid HA …but if your dog NEEDS the anti-inflammatory effects of Rimadyl to feel better so that he is up and moving around and building/maintaining muscle then you should use this. Of course it is always best to discuss with directly with his veterinarian who knows him. Hope this helps.

80. Thank you so much! He is doing better than he was so that makes me feel good. Toe grips are ordered. Can’t wait for them to get here. I think they are going to be helpful for him :)

81. Gillian I think that is a great idea…we love ToeGrips here at TopDog.

82. Vincent…I think you have a few options here. #1 yes you can increase the dose of the GlycanAid HA #2 You may consider switching the Deramaxx dosing to the morning. If you think about it…even though it is a 24 hour medication it has a bell-curve of efficacy, therefore if you are giving it at night the peak concentration are while he is sleeping and early in the morning. You may want to discuss this with your vet and give this in the morning so that your peak concentrations are when he is active during the day. #3 You may also want to discuss with your veterinarian adding in a moderate dose of tramadol into your regimen…meaning stick with the maintenance of GlycanAid HA…shift the Deramaxx to the morning..and add a little tramadol into the mix….Just some thoughts…in my mind option #2 and #3 are the best but do please discuss this with your vet.

83. Gillian if you are focused on quality of life at this point than from the sound of it an anti-inflammatory like Rimadyl sounds like a good idea. It is best that you pose this question to your veterinarian whom knows both you and his condition better than me..but I think it is great that his liver is tolerating the medication.

84. By the way I’m going to order him toe grips :) maybe it will give him confidence on slick floors. At the vet he won’t move past the front mat ( he starts to shake and is scared out of his mind) because she has concrete floors so they have a blanket ready to get him on and carry to the exam room. He’s a silly boy but luckily the staff are accommodating.

85. Dr. I have a 12 year old golden retriever named Hunter who has a cancerous tumor on his leg that is at least the size of a baseball (he has no other but has plenty of fatty tumors). I have seen multiple vets about this mass and I am getting a 50/50 split on whether it should be removed. One vet said he may not make it through surgery and if he does he may not be the same dog. Another vet says the opposite. Unfortunately the vet that said to not do surgery has convinced my husband. The mass doesn’t seem to bother him other than he’s a little stiff as it’s on the muscle. He also is starting to slip on floors and sometimes I’ve had to help him get up. Other issues we have are unknown spots on his lungs and some recent blood work indicated there is something going on with his kidneys. In addition to this he has shown signs of dementia. However, he is still happy and loving. He just has some quirks (he won’t walk on slick floors unless there in a rug within a half dozen steps he can touch) and sometimes I have to stand over him to make him eat. So we have decided to just make him comfortable and enjoy our time with him. So he is on rymidyl 1x a day, 100 mg tramadol 2x a day and 100 mg of gabapentin 1x a day. I have recently put him on some antioxidant supplements for his dementia and guclosemine for his hips. We’ve been doing this for close to a month and I think I’m seeing a difference. I did on my own after some research. My question to you is that with everything I’m giving him do you think I could take him off rimidyl? He’s been on it about a month now. After 2 weeks our dr tested his blood to make sure he was handling it ok and he was. However I don’t want to tax any other part of his body if it’s not necessary. Any thoughts? I appreciate your help! Gillian

86. I purchased Glycanaid Ha for my dog who is experiencing problems in his hips with arthritis and etc. After speaking with you over a month or so ago, I decided to order it. I give this to him along with his deramaxx. I doubled his dosage May 1-31, then started the maintenance dosage from June 1 to the present. The last couple days he is slightly experiencing difficulties again. The double dosage did wonders for him during the month. Can I go back to doubling up, or stick with the maintenance? His bad times are in the evening after I give him his deramaxx (my guess it needs time to work afer 24 hours). During the montyh, I would get home around 3, and let him out,a nd he would run and be kinda playful. Please advise.

87. Charlene if it is a fully torn ACl than surgery no doubt is the best option. At his age I would personally probably opt for the lateral suture repair which with good post-surgery home therapy, he should recover great. That said in addition to the Previcox are ou providing him with a good joint supplement and if so which one? I am here.

88. Shir, the dose of tramadol starts at 1mg/lb. That said some dogs are more sensitive to the drug than others so you may want to discuss with your doctor scaling back the dose. This truly is a 4 times a day medication though it is commonly used only twice a day. Also in addition to the anti-inflammatory do you have him on a really good joint supplement. This is the foundation to optimal joint health for starters?

89. Our 13 year old Norweigen Elkhound has developed arthritis in back and front legs. We did rimadahl for 2 weeks and he responded well on that. Wanted to try supplements, Dasuquin, so switched to that 2.5 weeks ago and he is having trouble again on stairs and getting up, has some inflamation on rear leg and licks his legs often. (Same symptoms as before)

    I understand that the supplements take 4 to 6 weeks to take full effect. So, what are your thoughts on keep going on supplements only, hoping it will start to be effective, or switch back to the rimadahl (with a blood test)

    Thanks

90. I have a 4 year old female shi tzu. She was limping lifting her right hind leg up. I took her to the vet and she was given meta am for 7 days. With the first dose she was putting her weight on the leg. We restricted her movements. This drug made her throwup 3x did not eat as much and was a bit lazy. On day 9 returned to the vet she told me she seemed fine. The next morning the dog was limping again. What should I do. Please help.

91. My dog was just diagonised with arthritis in the bones they give him prednisone and told us to do physical therapy and suggested surgery. I can’t afford it. Please advise me I’ve had him for 10yrs. I’m in tears.

92. Hi there,
    I have a 12 yr old choclate lab hes a large lab weighs (90 lbs) who has hip dysplasia and has been on privacox for the past few years.
    Last week he hurt himself, not sure exactly what happened, he came hobbling to me with his Right hind leg curled up. Vet took X-rays , lots of luxation in the knee they think it’s his ACL, eval with specialist is May 9th, 1st PT, opening is May 18th. I m torn between surgery versus pain. Management. I don’t know that he will come back from it, is strengthening a viable option?
    I’m 49 in very good shape and just recovered from ACL reconstruction 5 months ago, it is not an easy recovery and that’s as a human!
    Can you share some I sights.
    Thanks
    Charlene

93. I just received the GlycanAid-HA tablets. I can give it to the dog even though he is on deramaxx? These are awful large pills. The dog is 28 pounds, would it be best to give him two tablets at the same time or can I give one in the AM and one in the PM? Can I give it to him at the same time I give him his deramaxx?

94. Thank you so much for your reply. I do have her on joint supplements, not on omega. I will add that ASAP while the Meloxicam gets out of her system. Thanks for helping everyone.

95. Hi,

    This site is excellent. I have a 12 year old Lhasa apso boy. He ruptured both cruciate ligaments a few years ago but recovered without an operation. He has pretty bad arthritis. He has been on metacam once daily for a few years. He has been struggling in the past few weeks and was walking really slow and we took him to the vet. The vet suggested tramadol. He suggested giving our boy 2 10mg tablets in the morning and 2 at night. Gizmo is 11kg. He has been on them for only 5 days and he seems a bit spaced out and is sleeping maybe a bit more. Is this normal? Do you think this dosage is right? I also wondered if I should give him them in the morning and then at around 6pm when he is more active or perhaps give only one tablet 3 times per day? Finally, I am still walking him, short walks and at his pace? Is this correct or will it do him harm making him walk?

    Thanks so much

96. Lisa usually they recommend 3-7 days to wash the NSAID out of the system. The question I have for you is do you have her on a comprehensive joint supplement currently? Do you have her on a Omega supplement? I always make sure in my patients that I maximize natural support first and then utilize pharmaceutical management later if I do not achieve good results.

97. Rhonda no doubt what you describe is very strange. I think the best advice I can give you is maybe it would be worth taking the X-rays and getting a second opinion with a board certified neurologist…Even though you can’t afford the MRI maybe they would be able to provide more insight whether cancer is a viable option in this case. What you describe is so sad and there are other medications to consider for pain management that may not work better for your dog. I wish I could make it all go away for the both of you but I think getting a second opinion with a specialist would be worth the expense. Good luck. Dr.J

98. Hello. My baby girl, Belle has hip dysplacia in both hips, bad knees and arthritis. She is a big dog, a lab/hound mix. About 9. We walk daily, I take her swimming when I can, I spend all my time with her. She is my heart. I did a pain trail recently with Medicam and could tell it worked. I know have her on meloxicam once a day. The vet also gave me Tramidoll to give her at night, I don’t because she sleeps soundly, does not move around, I don’t think she needs it. It has only been a few weeks, I was considering adding organic turmeric powder to her diet but have read I can not give it with NSAIDS. I would like to try it instead of prescription to just see. She has some fatty tumors (all checked) and I have read it is good for them, as well. How long will it take the meloxicam to get out of her system? She gets about 3.75 mg a day. Do you see anything wrong with trailing it for her, I can always go back if it doesn’t work? How long would it take to work if it were going to as far as discomfort goes? Thanks so much, I just want her to be comfortable and happy. She is more spry with the prescription so obviously was in some pain, but as you have said, she hid it. After I saw her X-rays a few weeks ago I knew she had to feel something, though. Thanks again. Lisa

99. Dr. St Clair,

    My 10 1/2 year old Sheltie was in the prime condition of her life in July 2013- beautiful coat, sparkling eyes, great enthusiasm for life and especially doing rally obedience with me. In Sept, I noticed the coat going dull and she had some pacing/panting that developed, primarily in the pm. Some mild rear end weakness occurred when she would jump on the furniture…her rear would “give” upon landing. In Oct she became pu/pd and uriblnating during sleep, so she was worked up for kidney disease, Cushing’s
    but blood work was totally normal. Physical exam did reveal she was sore in her lumbar spine, so I did acupressure at home and baby aspirin. After no significant tmprovement, we did a trial reduction of her ThyroKare which helped but did not resolve the pu/pd. Repeated blood work remained normal. Physical exam revealed she is very sore in her thoracic spine. Xrays showed very mild arthritic changes in the lumbar area, but the vet is quite concerned about the thoracic spine looks. She mentioned a concern of neoplasia. We started Metacam and 24 hours in, Sophie felt great!! On day 6, she vomited….on day 7, she refused food and vomited undigested food from the day before. We stopped Metacam, but too late…on day 8 she was diagnosed with pancreatitis. She seems to be recovering now from the pancreatitis…she is eating a moderate fat premium senior kibble and her weight is slowing creeping back up. She is perfect at 24 1/2#….had lost weight to 23 and is at 23 1/3# today. She has been on Tramadol 25mg am and pm. It seems to manage discomfort well, but I am concerned with neurological signs I am seeing…very dilated eyes, noise & movement hypersensitivity, walking into door jambs, wobbly rear gait, mild hackney gait in front, and ocassionally tremors, esp of the head. How do I tell if these are new disease symptoms or side effects of the Tramadol? I have twice tried to reduce her dose to 1/4 tab, but both times she exhibited return of discomfort signs…pacing, panting and frequent repositioning. I want her comfortable, but the stoned affect on the Tramadol makes me unsure of her overall status. I would like to do acupuncture, but the vet is reluctant in case she has cancer and I cannot afford an MRI or other advanced diagnostics to confirm. Any suggestions would be appreciated.

100. Hi how are you
     My son brought their black lab back to vet
     This time he gave him an anti inflammatory drug not without asking for it though.

     Anyway for all the pain and such he endured he is healthy but the vet prescribed prednisone in low dosages as the tamrodol was not working alone

     May I ask your thoughts on this
     He is the 98 lbs black lab

     Do you think it’s just ad good ad rimadoyle

     Thank you again
     Have a good Easter Monday
     Laurie

101. Hi how are you
     My son brought their black lab back to vet
     This time he gave him an anti inflammatory drug not without asking for it though.

     Anyway for all the pain and such he endured he is healthy but the vet prescribed prednisone in low dosages as the tamrodol was not working alone

     May I ask your thoughts on this
     He is the 98 lbs black lab

     Thank you again
     Have a good Easter Monday
     Laurie

102. I meant rimydol sorry
     Thank you again
     Laurie

103. Thank you for your quick response
     There are some open Saturdays but it cost double
     I am in Ontario a small town
     Can I ask you about ramadol.

     I was doing some research and read that it was also a good medication

     Thank you again
     Blessings
     Ps. It is a good thing you are doing online to try to help others. I am sure you will be truly blessed
     Thank you
     Laurie

104. Laurie..most animal hospitals are open on saturday morning at least or at minimum some way of getting attention over the weekend. THough aspirin is safe and effective for dogs the reality is that it would be better to get her started on a more direct and potent NSAID from the veterinarian. This of course is used in conjunction with tramadol. If this dog did truly have a neck injury…you should be on red alert and then dog should be MAJORLY restricted. You best bet is get that vet back on he phone and get on the right medications. Good luck. Dr.J

105. Hi again
     Sorry I forgot to mention the dog is a black ten year old lab and weighs 98 lbs
     Thank you again for your time
     Blessings
     Laurie

106. Vincent..First off I think it is a good idea to speak with your doctor more specifically about this but maybe I can just provide my opinion or insight. Personally I really have focused on twice a day NSAID’s like Rimadyl vs. the once a day like Deramaxx. For me I think I get better more consistent management but remember that is just one persons opinion and your veterinarian may have a different feeling. That being said if your dogs arthritis is significant then an anti-inflammatory often is not enough and you need to incorporate some real pain management. Remember anti-inflammatories relieve discomfort related to inflammations they are not true pain meds. Therefore it may be a good idea to ask your vet about incorporating tramadol into his medication regimen. This can and will make a BIG difference. Also since I am a naturally focused doctor…I would have to ask and make sure you are giving him a really good comprehensive joint supplement as well. If you are not then this is a must..and please take some time to check out top dogs product called GlycanAid HA. By all means also check out some of the hundreds of reviews on this product over at amazon. You have to start with a solid natural core and then start to layer the pharmaceutical therapy on top of that with an NSAID and tramadol. Hope things improve quickly.

107. My dog has arthritis in his hips and was placed on Deramaxx once a day. He has been pretty good with it, but I notice he is limping more and hope the pain is not greater then how long the medicine last. I give him the Deramaxx in the morning becuase I figure he is more active, but he is starting to limp a bit more in the evening. It is prescribed once a day. Can I give him another one now, or wait until the AM for his regular dose. Also, would it be better he get the pill at night instead? During the day we are at work so he is not as active, but when we do get up, he does pace contastantly until we leave. When we get home from work he once again is more active. So when would be the best time to give him his pill, in the AM or PM? I do think he over did it today that is why he is limping more or he may have twisted to quickly. He is blind and does lose balance when turning. I will talk with my vet tomorrow.

108. Gillian I would follow along specifically with the guidelines set by your veterinarian in this case. You really want to rest her and limit activity until you get control of the excess fluid and allow the heart medications to kick in. These dogs can do great but it takes some time.

109. My King Charles Sasha has a heart murmur and was finding it very hard to breath we had to take her to the vet at 12 o clock on Friday the 3rd as I knew she would not have been here on the Saturday morning her lungs where full of fluid and her wee heart was racing the vet put her on 1 tablet called vetmedin and 3 fluid tablets called frusemiide to help her she has been doing very well her back legs are weak and I was wondering if the anti inflammatory and the traumadol would help her as I can’t take her for walks. She is on complete rest at the minute. She will be 13 this October

110. Vicki…no doubt and non-steriodal anti-inflammatory like rimadyl works and can be used daily in some patients. (routine flood testing for changes in liver values is necessary though). That being said the real question is what are you doing in terms of natural daily joint support? A daily joint health supplement like the one we formulated here at TopDog called GlycanAid HA can go a long long long way at optimizing daily joint health.

111. Micheal the first thing I have to say is…I am so sorry that I am delayed in getting back to you. I am so sorry. Unfortunately I did not know that my web team had set up two different locations for me to check and comment on peoples question and I only found out about this yesterday. I have been working hours and hours to comment back to everyone but there are hundreds and I am doing my best. That being said…I am going to go out on a limb in your situation like I have never done before and say YOUR VET IS TOTALLY WRONG!! Your description makes be so sad and unfortunately there is no standard that is used universally across the veterinary medical industry on how to manage chronic pain in dogs, like you describe. I am sure that your veterinarian is a very kind a good person but just maybe they are dated in their understanding of good pain management. If your dog is still in this situation I would be advantageous to get a second opinion with a veterinarian a little more schooled or sensitive to current pain management. Again I have to just say..that I love all of my veterinary colleagues dearly…in fact my father at 76 yrs old still practices with me today and he is a brilliant doctor, but he still is not sensitive or aware of pain management like I am with this older dogs. It is a generational difference and I continue to help him be more aware and open to the resources available to us. Hope this helps.

112. Robyn one thing I have learned in my 11 years in practice is…though there are standards for some things…there is insane variability in ways my veterinary colleague manage chronic pain or chronic conditions such as this. The BEST advice that I can give you is this…it never hurts to seek out a second opinion especially in your case with a boarded neurologist or orthopedist. If you dog is crying in pain or yelling in pain…then the pain is SEVERE. There are so many things you can do daily to not get to this point. :( I wish I could help more but since I am not your dogs personal doctor I am limited. Good luck.

113. Kelly, unfortunately I can not give specific recommendations on dosings of medications but what I can tell you is this. If your dog is 15 years old and has severe arthritis…the current medication protocol that you described is WAY OFF in my book. You may want to either discuss a better pain management protocol with your current veterinarian or get a second opinion. First off, HA alone is not going to cut it, and you need a comprehensive joint support supplement like our GlycanAid HA product. Second, daily non-steriodal can go a long way in helping to manage the inflammation secondary to the arthritis. Metacam is only one option…there are several others. Also a good and very safe pain med like tramadol can go a long long long way is helping to keep these older pups comfortable and willing to move. Good luck and get busy because she needs you right now. Dr.J

114. Kristin you need to talk to your doctor about the frequency of the Tramadol dosing. This medication honestly is a 4 times a day med. Personally I try to minimally use it every 8 hours ie. 3x times a day. Discuss this with your vet ASAP.

115. Emily, though I totally wish I could comment on your question I can’t because it requires a doctor/patient relationship. This needs to be discussed with your dogs doctor. I am so sorry :(

116. You need to no have your dad walk your dog on a leash or you need to have a quiet one-on-one sit down with him and tell him how you feel about this. Most of the time people simply just don’t know and need to be informed. Make sure you approach him from a position of love and not criticism so that he will be more receptive to your concerns. Thanks for watching out for you little one.

117. my dad has ben pulling my dog with the leash and he had lots of pain and he cried and know he is scared of my dad what do I do I am worried!

118. is it ok to give my dog turmeric, ginger and manuka honey while he is on meloxicam (2.5 mg) and clindamyacin (300mg daily)? thank you in advance

119. Hi, I have a 7 year old Havanese with arthritis, an old CCL injury and possibly a new CCL injury with his other leg. The vet has ordered 50 mg tramadol 1/4 tab every 12 hours and Rimidy 25mgl 1/2 tab every 12 hours, along with Glycoflex II chews twice daily. He still seems to be experiencing some pain throughout the day. His worst is in the morning upon waking. He has to be carried outside, and can barely stand long enough to pee because he shakes very bad. About an hour after giving him the morning doses of medication, his shaking subsides and he is ready for normal outside “potty time”. My question is, do you have a recommendation as to how I can prevent him from being in so much pain in the morning. Could his tramadol dose be safely increased? Is tramadol safe for long term use? Thank you for your help, your site has been very helpful!

120. Hi Dr.St.Clair
     I have a 15 yr old dog who is suffering from severe arthritis in her left hind.She has a hard time standing up and when walking she drags her leg a bit.If she stands in one place for too long her leg will buckle.I have just started her on Hyalauronic with a product called easy mobility.And when she is really bad i give her low dose aspirin.My Vet has told me that Medicam is not recommended as she might have the start of Cushings. Would it be safe to give her Medicam still ? Also would there be any adverse effects with the Hyalauronic and starting her back on tumeric as well?
     Thank you

121. Hi Doc. I have a 7 yr old Mini Dachshund, very healthy, 11.5 lbs, happy as a lark. However for the last year she has started showing early signs of a disc problem. We built her stairs and try to never let her jump off anything, but if she does manage to sneak around us and jump off something she will lie still and yell out in pain one quick sharp yell. After an x ray showed she has one disc that isn’t severely altered but enough to make her very uncomfortable at times My vet gave me a pain medication for her and a muscle relaxer and told me to give it to her on nights she’s hurting. But I never know she’s hurting until she wakes me up with a yell. I hate that she has to be in such severe pain before I know it. How can I keep her comfortable ALL the time and help her heal? Thank you so much. Her comfort means everything to me.

122. We have a 14 year old Brittaney Spaniel who is suffering from bad arthritis. It is to the point that she very seldom will go down the 10 steps to our Family room. This is where we spend all of our time and she has always been right by our side. She has had heavy panting for the last year and a half. We have an annual Vet appointment tomorrow but last year, at her annual check-up, we brought up her heavy panting and the Vet said it went will old age and that there was nothing we could do about it except try to get her to lose some weight. She weighs 55 lbs and just loves to eat even with her severe arthritis. He also told us that her arthritis goes with her age and nothing that we can give her will help make it improve. So no, she is not on any medication. The last 3 nights, she wakes up whinning and we have to get up to help her get up and move. Our Vet warned us that one day she will just lie there as she will no longer be able to get up at all. She always goes outside for her business but this morning, she could not bring herself to go down the 4 stairs, therefore did her business on the veranda. The main thing is, we do not want her to suffer and have agreed to put her down if this is the best thing to do for her? Please advise at your earliest as we are desperate in doing the right thing? Thank you so much.

123. My 8 year old American bull had acl surgery last May. He was doing very well until this winter. He slipped on the hardwood floor in November and started limping. I took him to the vet and he was put on rimadal(?) for 10 days. he came back around until he fell on the ice. We went back to the vet and another round of the rimadal (?). He stills is limping. Do you have any suggestions?

124. You are very welcome.

125. Thanks for sharing your insights and knowledge. It’s helping us with our rat terrier who has sever back issues. Thank you!

126. Hey diane, thanks for contacting us. Rare condition but awesome that your had access to the right team of smart people. As for the supplements I am going to be completely honest with you. There are only a few products on the market which I really like and trust but I am going to take this opportunity to make a case for TopDog’s GlycanAid-HA. I developed this product alongside an industry leader about 4 years ago because I was really unhappy with what was on the market at that time. So let me just explain a few things that are really important to me. #1 The quality of each raw material in a product is THE MOST IMPORTANT thing I focus on. #2 The origin of that raw material is also critical especially in todays market. #3 THe formulation has to incorporate the right balance of ingredients, proven natural anti-inflammatories to proven chondroprotectants. That being said we created a product that meets these three criteria and it is called GLycanAid-HA. Please take the time to read other pet owners reviews posted on Amazon. Here is the link: http://www.amazon.com/TopDog-Animal-Health-Joint-Rehabilitation/product-reviews/B004TLMNHE/ref=sr_1_1_cm_cr_acr_img?ie=UTF8&showViewpoints=1

     We are really proud of this. For the size and distribution of our company it is PROOF that we have done justice and produced an effective product, not only made in the USA but made with all USA ingredients.

     Second of course I would recommend on Omega 3 supplement called Flexerna which is derived for the ultra-pure oil of the green lipped mussel of new zealand. The key to this Omega 3 is the eicosatetranoic acid.

     Hope this helps. If I personally can help you in any other way or the topdog team can help please dont hesitate to contact us. 888-504-2220

127. I have a over active 10 mo. old Border Collie pup. He turned 7 mo. old i noticed his gait was off. Took him to my vet, possible ACL sprain in him left knee, he recommended rest, and rimadyl. Not much improvement, after 2 weeks. I took him to a vet/chriopractor. She didn’t think it was an ACL injury, knees were tight. After she adjusted him, we noticed a clicking in his right knee. Took x-rays of hips, lower spine, back legs, diagnoses was ephysitis due to overactivity. Most effected were his back legs. Hips looked OK. 6 weeks of restricted leashed walk. Only other activity he would do was swim. He’s doing good, I’m limiting his activity til I know the growth plates are closed. Following your guidelines to build up his rear. Can you suggest which suppliments might be helpful & anything else I can do to help him have a pain free live.
     By the way, he was not any more active than any of my other dogs. Maybe I was always lucky. Thanks in advance.

128. Honestly what your dog really really needs is strength training at a canine rehabilitation facility in your area. It must have an underwater treadmill. I will tell you from experience you can do great things with dogs like her…she still will always be “a little” weak but almost to full function. Second you need to purchase ToeGrips from http://www.toegrips.com this will make a huge difference for her confidence. If you don’t have access to a rehab facility then I would suggest visiting topdog’s online rehab center and watch some of the strengthening exercise videos…make a plan and get to it.

129. My labradoodle suffered FCE 2-1/2 years ago. Her back end was completely paralyzed and after treatments with steroids came back partially. Her right leg is worst, does not have a lot of control over it. Left is very good, but unable to scratch with it. She walks in house. As long as on carpet. To go out she is in Walking Wheels as she cannot squat without falling. Also in order to get exercise she needs the wheels. She has lost most muscle in back end and is all bones back there. She eats as much as she always did, but seems to be so slender now. Vet says she is in good health otherwise. If we try to increase her food she does not eat it all. Are there any supplements we can give her that will help her. Thank you.

130. I have to explain one thing first. Technically according to the FDA, arthritis is a disease. That said according to the law, when discussing the treatment of arthritis we can only discuss drugs or medications which have undergone clinical trials and approval by the FDA. Only only reason I bring this up is for clarity for consumers whom will read this in the future.

     That said we CAN discuss in general terms joint health management and support. In the case of your dog, me general rule of thumb is dog under 7 I would stick with the GlycanAid Maintenance formula and those over 7 I would stick with the GlycanAid-HA formula.

     That being said if your dog is doing well with GlycanAid-HA and you want to continue with this, by all means, yes you can. The only difference between the two is the addition of 25mg of hyaluronic acid. If you try the maintenance and you think the HA formula helps your dog more then you can always switch back. If there is not difference then stick with the maintenance.

     Which ever you choose, for your dogs optimal long term joint health using a comprehensive supplement like GlycanAid should continue for life. Reason this is recommend is that joints are in a continuous evolution or change and therefore the additional health support is valuable for long term health.

131. Kelley that is a really tough question to answer only because of the limited information I have about your dog. What I would first want to know is, when your dog is having one of those bad episode is he limping on that one leg that did not have surgery? Second I would want to know did your veterinarian sedate him to do a through orthopedic evaluation. A lot of time partial acl’s can be really difficult to evaluate. Has he had X-rays of his knees, hips, back and neck? Did the veterinarian do a hip laxity evaluation or hip extension evaluation? Lastly can you describe exactly what your dog looks like when he is bad and how long does it last and what do you give your dog for medication?

132. For a dog with medium arthritis, should he take GlycanAid HA for the first month and then switch to the regular GlycanAid without HA, or should he be on the HA formula for the rest of his life?

133. Thank you for all the wonderful posts and I am so sorry about your puppy dog. After reading the doctor’s response, I am worried that may be what is wrong with my bulldog. He tore his ACL in 2006 and went through surgery. He is now six years old. Last Aug., he was crying and had great difficulty getting up. I took him to a vet (mine was out of town) and she said he tore his other ACL. I got a second opinion with my vet, and he said he didn’t think he did. Anyway, every so often, (about every 3 or 4 months), he cries out in pain and has trouble getting up. My vet has given him a steroid shot and that has always seemed to work. He is on a joint supplement and 90% of the time, he is his regular self. Should I be concerned about his neck or back? Thank you!

134. Thank you very much. You said I have a bit of room for med tweaking-can you tell me what that might be? Also, a board certified vet has asked me to consider hip denervation for her hip OA, but said it isn’t always successful. Can you comment on that as well?
     thank you,
     Marilyn

135. Vikki, I think it is important that we separate discomfort related to pain and discomfort related to inflammation. When it comes to joints until the severity becomes real bone-on-bond the majority of discomfort is related to inflammation. We all accept the fact that there are natural anti-inflammatories out there in the world. Tons of research as been done on several of these ingredients. In fact GlycanAid HA includes three of the most well known and proven ingredients. This most likely is part of the reason that Snickers is doing so well. Also you have to give credit to the hyaluronic acid which is such an amazing ingredient.

     When it comes to true pain management, though some opiods are considered natural, they are generally regulated as drugs and controlled substances for that matter. Tramadol for example is a synthetic opiod which has a very good safety profile and works, though some dogs can be sensitive to the drug and have exacerbated sedative effect the vast majority of dogs tolerate tramadol extremely well.

136. I have an aging 10 year old chocolate Lab, Snickers with terrible arthritis through many of her joints. I have tried metacam multiple times and had to take her off due to stomach upset. The vet has also prescribed Tramodol but we found that she was so spacey her quality of life was declining on the drug.
     Recently I went a more natural route of fresh ginger and organic tumeric on her food along with your Glycan Aid HA and the results have been dramatic. For the first time since we adopted Snickers 5 years ago she ran and fetched a ball on our daily walk. She is far more alert these days and more engaged with my other labs. I believe that the ginger and tumeric are decreasing the inflammation with the glycan aid aiding the joint but are there more natural products for pain control?

137. Dr. St. Clair — thank you for your response about Bruin — I find this site invaluble — it really enforces upon me the need to strictly restrict Bruin’s activity. I have been trying to purchase flexerna for him, however it seems to not be available for large dogs — he’s over 90lbs — will it be available soon?

     thanks!

     Randi

138. Randi I am not quite sure where you read that the meniscal tear with the cruciate is a bad thing of altered the potential for a full recovery or normal life. In fact these two injuries often go hand and hand. I apologize if there is content that lead you to believe this. What I think is far more important than anything is trying to get pet owners to understand that FULL recovery most of the time is a 6 month process. What I mean by that is..I would not let a dog off leash to run around like a crazy person at 12 weeks or 15 weeks unless I knew that physically he/she was 100% back to normal. At 5 weeks post-op you have a long time to go but is sounds like he is doing better right now.

139. Martin, of course I understand your concerns. There are no doubt potential for adverse reactions with any medications. That being said…in the grade scheme of things these medications are extremely safe. The problems really have been due to lack of consumer education that if there are any signs of GI distress then the pet owner needs to stop the medication immediately. Many people do not see or are aware of the initial warning signs. Once the medication is stopped all is well. As for the liver, yes like any toxin the body needs to eliminate it from the body. This is via either the liver or the kidneys. Again..if veterinarians and consumers used the medications properly and took the time to run bloodworm 2 weeks after starting the meds to check how the liver is tolerating it…there would not be a problem. So again I understand your concern and by all means I focus far more heavily on the proven natural anti-inflammatories that are available to us prior to the pharmaceutical solutions.

140. I have serious concerns that Rymadyl or any of that class of drug be a long term pain solution. When my dog had ccl surgery Rymadyl caused stomach issues. Martin

141. Yes Dr. St. Clair, I did forget to mention that she is on a dose of 2 cosequin ds, 2x’s a day. Is that sufficient? Thanks again :-)

142. I have been on your website (and receiving your great emails) since my black lab Bruin had TTA surgery to repair his torn cruciate – he is about 5 weeks post surgery and I think he’s doing well. However, he did have a meniscal tear and I just read on your website that the long term prognosis for dogs with a mensical tear in addition to the cruciate is not great. Bruin is 4 years old and had a partial tear to his acl at 4 months (I didn’t own him at that time). He was crated and it healed without surgery. He came into my life when he was 11 months and walking perfectly. He started limping in January and had surgery in March — I tried limited activity first.
     Should he be getting adequan shots? I went through this many years ago with my yellow lab Maggie who had both knees repaired (way before TPLO was performed) and ultimately had a slipped disk in her neck which I had repaired. So I’m very upset for Bruin — what else should I be doing for him? Right now post op he’s on vetprufen, dasaquin and omega 3.

     thanks

143. Wow Julie that was so unfortunate. Obviously the great thing is that you persevered and now she is doing well. As for the left leg I would assume that over time she developed enough scar tissue on the outside of the joint to stabilize it to some degree. You have to also remember that having 4 legs is an advantage because she can subtle compensate on the other 3 limbs. In terms of just one tramamdol per day…..you no doubt should be able to stop this. Honestly it can’t really be doing to much on a once a day dosing considering this is a 3-4 times a day medication. The only thing I did not hear you mention is what you are doing for her in terms of natural joint support. Make sure that this is daily and lifetime ritual for her moving forward. This is critical.

144. Hey Susan….ohhhh my buddy Jake. I wish I could just wave a magic wand and fix him. So the absolute first thing that came to mind was do you have a canine rehab facility near you that has an underwater treadmill. If you did and you were able to get him into that tank twice a week, you would most likely see an improvement in 3-4 weeks. That said it would be difficult for the first few weeks and he would be very tired after his sessions. If you dont have this available to you or can’t do this then I would do two things. Instead of Deramaxx I would personally go with Rimadyl twice a day. I would do this for a consistent 7 days and monitor changes or improvement. I would also strongly encourage you to to this site http://www.toegrips.com purchase these to help with traction. Dr. Buzby is a personal friend of mine and these are awesome. You just have to take some time to put them on properly, but they can be life changing. Hope this helps some.

145. Dr. St. Clair, I have a long story that I will try to make short. My then 8 year old lab mix tore her left acl. I had mrit done and she got a bad infection and was on antibiotics for a very long time and had all materials removed. Of course the mrit failed. Then she tore her other acl and so I had mrit done on both legs at the same time. They said that these sort of failed also, so I took her to MSU and the doctor did tplo on her right leg but said the left leg was too much of a mess. In the mean while she is doing VERY well on both legs. She doesn’t even limp!? She runs around like a pup most of the time. How is this possible.The rimadyl I had her on started upseting her stomach so I took her off of it around mid February and now all she gets is 1 tramadol a day. Should I continue with the tramadol or could I possibly try taking her off of it also? She is now 9 and all these events happened in the last year to year and a half. Thanks for any advice you may have.

146. Dr. St.Clair, I have a 14 yr old Golden Retriever, Jake, who has very bad hips and arthritis. Your advice has helped this past year. He’s on GycanAid Ha, and we used your exercises to help strengthen his muscles. I also have your Harness system, which helps when my 88 lb friend can’t quite maneuver his weak hips (rear feet knuckle under and right leg weak).
     My vet is helping manage his pain, but I see him struggling now to walk, and although his spirits are great I’m not sure if it’s time to put him down. The past week, I’ve been using the harness system to get him outside. Scatter rugs in the house help him walk somewhat ok
     Based upon the meds he’s getting below, is there any “tweak” you can suggest to perhaps help?
     Meds
     – Sulcrafate 1 gram tablet 3x day (1 hr before eating or 2 hrs after)
     Amantadine – 100 mg cap – 1x/ day (am)
     Gabapentin – 300 mg cap – 2x /day (breakfast, dinner)
     Tramadol – two 50 mg caps 2x/ day , three tabs at night
     Famotidine – 20 mg tab- 1x /day ( at breakfast)
     Fish Oil – 1200 mg- 2x/day (breakfast, dinner)
     GlycanAid HA – 3 tab in AM, 1 TAB in PM

     We recently tried Deramaxx (1/2 of 100mg tab) in AM for one week. It seemed to help inflammation, but his hips seemed more wobbly, so I stopped a couple days ago to see if his walking improved.

     I know time is limited, but if there is something I can do to help him in any way? Your knowledge and advice has always been “spot on” for my furry friend.

147. Jill I am a huge fan of cold laser therapy, though I have not written about it all that much. We use this in our practice on a regular basis. For me this is just one part of a total multi-modal treatment approach. No one thing does everything. What laser therapy does is introduce energy back into an area that has been often forgotten by the body such in the case of chronic joint disease. This works on a cellular level to in essence re-stimulate the natural heal process of the body. The results can be amazing but again it is just one part of a much bigger picture for effective management. Combined with the right supplements, exercise and pain management it will no doubt help.

148. Paul you are right about having to be careful with using the aspirin over the long term. This is why they have developed the Cox specific or Cox selective non-steriodal anti-inflammatories. These drugs are designed to be more specifically target to blocking bad inflammation where was aspirin will block even the good GI prostaglandins. As for the Move Free I am not familiar with this but if it is a glucosamine supplement, yes you can totally used the tramadol with it.

149. Sorry for you lose Manny. This always makes me so sad but all lives eventually do come to an end at 12 years old for a big girl like her is tremendous.

150. Tish you may want to just try him on tramdol again at a long dose, and as you stated give it minimum 2 times a day but ideally 3-4 times a day. You also may consider trying a differnt NSAID. Also I would strongly encourage you to have him on a joint supplement like our GlycanAid HA (if you dont already). They hyaluronic acid makes a huge differnce. That said I also think acupuncture can be extremely effect for chronic pain management. Lastly the key to these guys is keep the pain under control so that they can still exercise because keeping good muscle tone and strength is vital to support the bone and joint. Once more thing…from experience if you could do the hydrotherapy I will tell you at first it will be difficult for him but I promise you the reward is immense on so many level both physiologically and physically.

151. Sounds like you have an awesome gang and they have an awesome mom who devotes alot of time to them. The one thing I would say Kerry is that with Bear just know that eventually the Metacam is not going to work as well as it once did. With all of these NSAIDs eventually the liver get proficient at eliminating the drug from the body, so just be sensitve to changes with him. In many cases I then will switch to another NSAID or simply add tramadol in eventually. You just have to keep you eyes open to the subtle changes.

152. Sandy she should 100% continue with this for a lifetime and yes I would continue with the GlycanAid HA. I am so happy that she is doing well.

153. Brooke first I would want to localize that popping sound. It may be coming from the knee. That said I would absolutly have her checked out by your vet. I would also say that she is a perfect candidate for a short term pain trial just to see if she is in any pain.

154. I can understand your perspective for the act post-surgery because in some sense you want them to be quiet and therefore if they are in pain then they will be more likely to be quiet. I have heard of vets who also have this philosophy. I always think to myself if I just had major orthopedic surgery where they cut through my entire bond and rotated it and put a plate to stabilize it, that would be seriously painful. I am sure I would want pain meds.

     That said, that article is really more focused on dogs who are suffering silently with chronic joint pain and not the acute post-op dog.

155. Linda you are welcome I you guys will be in my prayers. I really really really dont like cancer.

156. Teresa it is awesome that you did all of the physical therapy. That made a HUGE difference I know. As for the supplements you are using. The glucosamine/chondrotin in the food is BULL if you ask him and simply a marketing thing. I would stick with a separate supplement. As for the powder all I would want to know is who is the company and what are the source of their ingredients. If you want the best then you need to request what the source and origen of the ingredients are. This is something that I am massive passionate about.

157. Cassie I think you mean TPLO if you are talking about the knees. A TPO is actually the short for Triple Pelvic Osteotomy which is a surgery for the hip. So I would probably write for a long time about your dogs situation but heres the short of it. Your doctor is right about the other knee but this is not 100%. If you where to do this first knee surgery and then really work hard to recover your dog post-surgery and take a holistic approach to his long term joint health management..Ie. get him to ideal body weight, learn how to condition him and build ideal muscle composition, keep him on a high quality joint supplement like our GlycanAid HA and lastly learn how to properly evaluate him you very well could never have to have a second surgery. As for the Rimadyl, do not stop using this simply because of you fears and what you read online. This still is a very safe drug. What you need to do is to have a simple liver blood test prior to using it and then 2 weeks after using it…if the values are the same then your dog will have not problem with this drug. If they are elevated then I would stop the medication. Lastly, the TPLO is a great surgery. Is it the surgery for everyone…absolutely not. There are several types of repairs for this kind of injury. Just discuss this with you doctor. I wish you guys the best luck….if you use the resource we provide and ideally get him to a professional dog rehab facility he will do great for years to come.

158. Susan I am so sorry about this. I would agree with you that tramadol would be a great choice for her right now. Lets put it this way….you are not doing any harm to her and only possibly keeping her more comfortable. Just remember that tramadol is at minimum a 2 times a day medication but ideally it can be given 3-4 times a day at a dose of 1 mg/lb. It has a good safety profile and the dose can go significant up from here. Susan you have nothing to lose. If you give her the medication and you literally see no difference in her at all then you can stop it or just continue due to her condition and prognosis. I will pray for you guys susan. I am bummed.

159. Marilyn from the sound of it you are doing a decent amount of pain management. With the supplements you are at least getting some degree of anti-inflammatory on board so I would not stress about the NSAIDs. I feel your pain with differentiating the clinical signs you are seen. A question I would have is…do you find that she “gets lost” i.e.. does not seem like she is all there and second do you notice any patterns to these behaviors i.e.. is it more at night? Have you tried any of the supplements available for cognitive dysfunction (sentalife or neutricks). You still have some room for pain med tweaking but not a whole lot.

160. What a sad story Jen. You heart is so very much in the right place. I wonder if after having had such a long chronic problem if he did not have substantial arthritis in his spine. I can tell you that I have seen this several times over the years where a dog, because they for a long time have dealt with back leg pain…they have compensated and distributed that additional weight to the back and the front legs. Over time the neck eventually wears down and many of these dogs herniate a disc in the cervical region. I can’t tell you how many dogs I have seen over the years that get referred to me for hip dysplasia and difficultly with their hind end yet when I evaluate them….their real problem now is in the neck. As for the GlycanAid or cartophen injection not making much differnce that would make sense. These supplements are for synovial joints (ie the hip joint or knee). Since he had an FHO is will not help because there is not joint after the surgery. Also they will only help minimally if the dog has significant spinal arthritis. You are a great person Jen and should not feel bad at all. You gave him the most important thing which was love.

161. Dr. J…. Last January, I was desperate–desperate to help my 2nd dog, one I had adopted only 18 months ago from a shelter. He had been found, horribly malnourished and limping. He required an FHO soon after I took him on and had been living with a VERY old hip dislocation, according to the surgeon. He panted constantly before and after the operation. I had no idea how old he was or why he panted all the time. My vet recommended testing him for various things including Cushings (which he didn’t have) but really the vet had few suggestions. I had him on your Glycanaid and we dutifully followed your exercise/recovery videos but I could tell little about whether it was helping…When I first got him, he could get into the back seat on his own and could climb stairs. By this past January, he couldn’t get in the car and cried out when I tried to lift him into the back seat. My vet put him on Rimadyl. We tried cartophen injections as well –with little difference– at least I couldn’t tell if it was helping. He began hanging behind my other dog during walks. One cold Friday night, this past January, I arrived home to find him lying in his own mess (something I’d never seen). He couldn’t get up. I couldn’t assist him to get up as he couldn’t stand. I enlisted a neighbour to help me carry him to the car and raced to the vet. (The vet, I might add, knew I was coming but went home for dinner nevertheless, leaving us to a stranger.) On my own and at my wits’ end, I had to decide to put him down. Just as you’ve said here, I had lousy — or at least outdated–advice. This dog was clearly old, a shelter dog, and beyond the expertise of this veterinary practice. After all the x-rays and meds and injections, I never really knew what was exactly wrong with my dog. Twice, we went to the vet because he was suddenly limping, for example, but no diagnosis was ever made. So, I get “old dog” but truthfully, my experience here taught me that having a conscientious vet is so important. Pain management was just not on the agenda here. I knew my dog was in pain. I should have listened to my instincts and taken him elsewhere. Needless to say, I am no longer going to this vet….Thank you for this article. I wish I had read it last January. Maybe this poor old guy would have been able to live a longer and less painful life, for I now realize he was probably in constant pain. I will never forgive myself for overlooking the obvious….

162. Yup. The key is to, at the first obvious sign of pain (loss of mobility in a joint, unwillingness to stand or climb or descend stairs), give the dog an NSAID and 20 minutes later, try again. It works for the chocolate Lab that I work with. I also encourage the owner to not refrain from moderate regular exercise as flexing and stretching the joint has long term benefits.

     Thanks, Dr. St. Clair

163. How do I do a pain trial if my dog doesn’t tolerate NSAIDS?
     She has degenerative disk disease in her spine and OA in both hips (14 yr old springer spaniel). She is on Tramadol 75 mg and Gabapentin 100 mg (bothare 3 times daily). I still think she is in pain, but am wondering if it is Canine Cognitive Dysfunction as well. She limps badly especially on her rt rear leg.
     She is on supplements as well (Glucosamine,Chondroiten, MSM,yucca,turmeric,green lipped mussel (Sasha’s Blend), Omega 3’s, Vit C&E and a few Chinese herbs prescribed by a Holistic Vet.
     She does some pacing and circles in tight circles several times a day.She has pooped in the house several times the last few months,but never urinates in the house. Sometimes she starts to lay down,goes about half-way then gets up again (over & over). I don’t know how to tell if it is CCD? & how much is pain. Or is it all CCD. My vet is not extremely knowledgable with pain control in dogs.
     Any suggestions??
     What can I do. I know she is near the end of her life but I want it to be the best it can be.

164. Dr. St. Clair,
     I know I am off the beaten path when I mention my dog. She does or who knows maybe she does have arthritis. She had ACL surgery in October 2012. Anyway, my dog was just diagnosed with lung cancer. Everyone feels she should be on pain medication and I agree. Would Tramadol be a good opiod for her pain? I just want her to be so comfy in her final days. She is on Predisone 20 mg per day and also an inhaler. But I feel she may be in pain and I think her Vet need to address this more. He feels she isn’t in pain, but being a nurse I know lung cancer patients are in pain and so therefore our furry children are most likely having discomfort too when they are enduring cancer.
     Thank you

165. Did I make a mistake? My 9 year old chocolate lab is from the pound – he was abandoned because he has such bad hip dysplasia. He now has an ACL tear and the doc wants to do a TPO – I have read your thoughts on the TPO but my doc said that because of Tony’s bad hips the other knee will go. And also that after the surgery Tony can’t jump on a chair. I have a ramp for him coming to bed but he can’t seem to use the ramp going down. He is on Tramadol and I stopped the Rimidal because of my fear of liver damage. He had low thryorid and takes thryotabs. Final word: do I do the TPO he has lost weight and is now down to a good weight. I really really enjoy your newsletter/blog. thanks

166. My Yorkershire terrier who is two years old was born with perthes leg syndrome. He had a FHA surgery and 16 physical therapy sessions. He has no limping . I have him on fish oil twice a week and glucosamine/chondroitin which is in his food plus I add a powder form of joint care from a commercial dog care company. Should I do anything else ? I just put my 14 year old dachshund down due to severe arthritis and we did alot of meds which all just upset his GI system

167. I cannot tell you how much you have helped me. My dog, Lexy, broke her front leg, during surgery they thought it was bone cancer. I said go ahead with surgery, and it did turn out to be bone cancer. A very long rod was put in along with screws. Your site has been a life saver. I am now in the situation of trying to adjust pain medicine so your comments about pain management is a God send. I feel so lost eventhough I have wonderful vets, your comments are so appreciated. I thank you so very much for sharing.

168. I have a problem with this as my dog had TPLO surgery and was medacam and tramadol and in 48 hours he was lifting his surgery leg to pee. I feel these meds mask pain so of course they will feel better.

     I was intruged by your topic but disappointed with the solution.

169. Dr. St. Claire,
     My golden retriever had HFO on her left hip last year around this time. She was only 9 months at the time. I heard a popping in her hip when she walked. After, many trips to the vet, I finally convinced the vet to do an x-ray. It showed severe hip dysplasia in that left hip. Now a year later, I hear popping again. Could this be her other hip? She has never been very active. I am wondering if she is in a constant state of pain. Should I get her other hip checked out? Is this something that would show up after one hip has been fixed? Thanks!

170. My Pembroke Welsh corgi is Cammie. She hurt her acl Nov 2012. I decided not to do the surgery and give her an opportunity to heel if possible. I made this decision after reading your articles on acl injuries. I put her on a double dose daily for the first month then a single dose thereafter. She has been on GlyCan HAFactor since last December. She is doing wonderful! She is playing and running and appears to b fine. I am very grateful for your info. Should I continue her on this supplement for lifetime and should I continue using the same thing? It is nearly time to reorder so I would appreciate a response as soon as is convenient. Thank u so much and Cammie thanks u as well. Sandy Kleine

171. I like reading about topics concerning my dogs. Bear is 12, Rudy 10 and “Hank” will be 1 in a couple of days. Bear is on Medicam and is moving much better than he was a couple of years ago. Our Goldens’ play a big part of our lives. I show them in Obediece/AKC.
     Bear has finished his UD and Rudy (Hanks sire) has his UDX and has his NJP in agility. Bear is retired and Rudy loves his agility runs. I training Hank to follow in his Uncle Bear’s and father’s footsteps. The supplements make a big difference in their active lives as well.Blessings, K

172. I have been an advocate first for pain management in humans beginning at the National Institutes of Health. I now teach and have a 15 year old part basset/part terrier who has horrible arthritis. He has been on an anti-inflammatory, Metacam, for approximately two+ years. He has 3 legs and lost one to cancer (2010), so the remaining leg and hip are full of arthritis. I have seen the x-rays. His walking in the past 6 months has decreased, however he still wants to take reasonable walk with breaks daily early in the day and a very short one later at night. I limit him on days when he is having a lot of difficulty. His heart wants to walk but his hip and leg limit him. I am sure his Vet would talk to you (fairly sure). He was on tramadol once before but I thought it made him woozy and off balance. I did not give it a full chance and was only giving one prn, which is not the way to give it. So, I am taking your information to my Vet this week and see what she says. Other recommendations have been physical therapy (water) and acupuncture. He is not a water animal and there is only one therapist in the area (DE) that does it. I would try the acupuncture as I have had it myself and am open to it, however with my research background, I support your approach.
     Thank you so much,
     Tish Wolskee
     Health Psychologist

173. We had our Great Pyrenees Athena on 1/2 7.5 mg metacam and 2 50mg tramadol which really helped her continue walks. She eventually could not stand up and after much consideration we let her go. She was over 12 years of age and 90 lbs. She had a great life. I agree the pain meds made a real difference and worked for some time.

174. Hi, Thanks for the very important information. I was wondering if my dog could take Tramadol 50mg with “Move Free” with MSM and vitaminD3. So far I have had remarkable results with “Move Free” but at times my dog does need a little tweaking like an aspirin. Because of stomach problems I have had with aspirin I cringe when I give my dog (coated) 325mg aspirin. Thank You

175. I have heard that laser treatment alleviates pain due to arthritis – does this reduce the need for medication? What part does laser treatment play in pain management and do you use or recommend this treatment?