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Discussion Starter #1
Honey passed hers with flying colors!!! Everything was normal including her bloodwork.
Kelly's was really a pleasant surprise.
His ALT values are down to 191, the rest of his bloodwork was also normal!!! He's been having problems seeing at night and he may have the beginnings of his retinas atrophying. Since his ALT values are doing so good he'll continue taking the amoxicilline.

While we were there, our vet introduced me to a vet who specializes in veterinary rehab and works with older dogs. While what she does is physical therapy, legally in FL it can't be called physical therapy on animals. I had been planning on taking Kel and Honey for Bowen Therapy, but figured I'd try this type of therapy first.

Kel had his LONG two hour appointment today and will have therapy Friday. She worked some on Honey. Honey will have her LONG two hour appointment then. She'll work some on Kelly.

Kel laid on a magnetic bed while she stretched, massaged, and "pulled" his various joints, paying particular attention to his elbows. It was remarkable. She measured the various angles before and after the therapy and there was a big difference in his range of motion. He was supposed to start taking Pred today (after a five day hiatus from Metacam), but this doctor wants me to wait until tomorrow to see how the new therapy did without the help of new meds.

Honey wasn't too impressed with the procedure, but she seems to feel better. Both Kel and her can now move their tails.

I'll post more after their appointment on Friday. I have to drop them off and then pick them up in the afternoon because I have a lunch date with a friend I haven't seen in ages and didn't want to cancel it.
 

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Yah to Honey & Kelly! Massage Therapy is amazing isn't it Gayle? You see instant results and they look like they are so much more relaxed. The magnet bed is a great investment when there is a senior around!

Yes do give us an update after the Friday appointment.
 

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Oh Gayle, sounds wonderful.

And that rubbing and stretching (since we can't call it physical therapy) sounds great. I think *I* need to lie on a magnetic bed and have someone massage and stretch and pull my aching joints. Creeeeak!

Where do I sign up?

Truly, good news. Especially for Kel. I think he should be "last bite" dog tonight. Or maybe, just some extra snacks for doing so well. He's clearly working hard on staying healthy!
 

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Kelly started his pred on Thursday and Friday he was gagging and having dry heaves. He'd only had three doses. I called the vet and she said to stop the pred and wait the five days and go back to Metacam. BUT Metacam wasn't working for him, that's why he was put on pred.
She also had me start him on some of Ringer's Sucalfate which I still have in the medicine drawer (so glad I didn't toss it after Ringer went to the Bridge).

He didn't eat yesterday so I gave him a can of meat and he ate that, nothing else. Today he ate maybe 1/2 his breakfast. I won't even try giving him kibble for dinner, I'll give him a can of meat and make a couple scrambled eggs to go with it.

The rehab isn't working as much as I'd like to see. It's helping some, but his arthritis is really bad in his elbows. He's having a hard time walking anywhere.

I'm cancelling his appointment with the rehab vet tomorrow and will get an appointment with his regular vet instead. I'm hoping she'll be able to come up with something to get his pain under control. It's the only thing I want for him, to ensure he has a quality life and right now I can't do it for him.
 

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Aww No! Sorry to hear that Kel is having a rough time. Have you tried massage therapy with him? I find that makes a big difference with Mas as well as the magnetic bed. I used the palm mag on Mas when I could borrow it from my vet, I saw how much of a difference it had on Mas's mobility and over all physique.

I would be interested to hear what the vet suggests tomorrow.

Good luck Gayle, I'll be thinking of you.

Ruby
 

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I'm sorry to hear about Kelly. My ex had a dog that was put on pred and he had a terrible time with it too. Is that why Kelly isn't eating or is the not eating something else? I hope the vet is able to come up with a really good alternative tomorrow.

I understand completely how you feel. I've got Chama who has terrible arthritis and lung problems and Cleo (my 16 yo cat) who has terrible arthritis and periodically likes to stop eating. She also refuses all supplements and medications.

I can't give Chama NSAIDS because she also has some liver problems. So she's on a triple does of joint stuff and she also gets anti-inflammatory herbs at night. Her food is grain and potato free because both of those exacerbate arthritis. Her knees are completely shot and she uses her hip flexors for everything now. I am worried about how she's going to do at my cottage which has always been her favorite place in the world.
 

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Thanks Ruby - I forgot to mention I was going to try to get him in for a Bowen Therapy massage which helped Ringer so much. It's funny, tonight he seemed to feel pretty good (pretty good for a boy with all his problems). He ate some rice and a hard cooked egg along with some canned meat. I was going to give him some egg foo yung (sp) but it had a lot of seafood in it and I didn't want to upset his tummy any more than what it is.

Ruby - Kel was starting to leave a small portion of his meals before the pred, but he's just not eating kibble now. Today I ordered some joint remedy his rehab vet suggested (I was having a difficult time finding it) so hopefully that will help. I may have to put him on some sort of soft diet, I don't know yet but will keep grain/potato free in mind when finding something. I wonder if the Evo 95% All Beef canned is a complete diet? That's what I feed them with their kibble and I know he loves it.
 

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Kel didn't eat much of his breakfast so I gave him a can of meat which he immediately ate. I'm really concerned. The Hooligans are not picky eaters, when one doesn't eat there's something wrong, even when they're only eating soft, tasty treats like Kel is right now. I cancelled his and Honey's appointment with the rehab vet and got one for him with his regular doctor for this afternoon.
 

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I am glad he ate the canned food. I wonder if something is making it hard to chew or if it's just easier to eat that canned (and tastier)? Is it extra hot there or anything like that?

He's already on Tramadol isn't he? Do they do pain patches? Or am I way over the top here on that.
 

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I'm not sure what's up with Kel. I got a case of Canadia canned food and a case of A/D which should be enough to keep him fed for a week or so.

Then we're going to start using Pancrezyme on his food which should make it easier for him to eat and digest his meals. I'll order it tomorrow and hopefully get it this week, then I want to find out how to contact that lady who buys the enzyme in bulk and resells it in smaller packages at a decent price.

She increased his Tramadol to 100mg 3x a day.

She also put him on winstrol (stanozolol) anabolic steroid which should help increase his muscle mass. He'll have to have his BP monitored.

She also gave him a vitimin B12 injection.

I'm not sure if Tramadol comes in patches or not. I know when Niki was on the fentanyl patches they didn't help much with his pain and he got terrible bleeding dermatitis under the patches.
 

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He ate a can of Candia and a can of a/d. He felt perky enough to challange the dogs next door to a fence fight (he only took a few steps). He barked at my handyman when he came to mow the lawn. He was very tired after this, was limping more than usual and had a hard time walking up the ramp, but the fact that he did something besides lay around is positive.
 

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Oh good work Kel! That's the thing about this amazing breed, they really do find the energy somewhere to just keep on with routine and structure eh? Bet that felt good for him as well.
 

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Jean, my vet said that Fentanyl patches are an option for dogs that are in pain but otherwise in pretty good shape. Depends on the situation of course, but if pain management is your main issue, then he said, "sure, it's possible." He also said that there are stronger narcotics than Tramadol. That's not the strongest drug by any means (as it wouldn't be for a human). The issue at some point becomes quality of life. But some dogs respond pretty well to narcotics without feeling totally doped up (just like some humans, whereas others are just zombies). So if the dog is overall doing well, and the main/only issues is pain management, it's worth talking to the vet. And if the vet just maxxes out on Tramadol and Rimadyl, then I think it'd be time to look for another vet who's more open to the possibilities.

Hmm. Now I'm thinking, I wonder if there's a specialty for pain management? This is a pretty new specialty for human medicine....I mean, an orthopedic could handle these issues, but a true pain management specialist? Hmmmmm....

(Off she goes into cyberspace to see what she can find....).
 

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Ok. Off to a good start. Look at this:

There's no official Pain Management Board certification yet. But Colorado State Vet school has this program. There seems to be some inter-working between CO State and WA State University Vet school as well.

International Veterinary Academy of Pain Management (Colorado State) http://www.cvmbs.colostate.edu/ivapm/

FIND A PROFESSIONAL (Has links at the bottom)

http://www.cvmbs.colostate.edu/ivapm/professionals/find_prof.htm


http://www.avma.org/onlnews/javma/dec01/s121501g.asp (links at the bottom to further JAVMA articles)

http://www.cvm.ncsu.edu/vth/clinical_services/ipm/ (North Carolina State)

Appears that only Colorado State and NC State have pain mgmt programs.

(I found this informative enough that I actually printed it. It discusses such things as TENS units, drugs like Neurontin (Gabapentin) -- which is actually an anti-seizure drug, but it's used with rather considerable success in treating humans with some kinds of pain syndromes; and it talks about surgical pain. In other words, it's something I want to refer now and then to remind myself to make sure my regular vet/surgeon/specialist is thinking both in- and outside the box.)
http://www.aahanet.org/PublicDocuments/PainManagementGuidelines.pdf

For those who can't ever own enough books, this looks interesting: http://www.amazon.com/Handbook-Veterinary-Management-James-Gaynor/dp/0323013287
 

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Thanks for the information - can't wait to read it. Ringer & Honey both took Gabapentin for a few months for severe leg thrusting when they were asleep, I wonder if the leg thrusting was being caused by pain????
 

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OH! Cornell also has a Pain Management program.
Cornell.

I know that those of us who seem to spend a lot of time here in the senior section are really looking at that as something that can improve quality of life and I am appreciative that vet medicine is going that way. And will probably surpass human medicine!

How is he doing, Gayle?
 

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Re: Honey & Kelly's 6 month physicals!

Cornell too?

If Cornell, then does Tufts? Those two always seem to be trying to be one-upping each other (which is so great for us and our dogs). Hmmm...

I'm wandering off into Cyberspace again. I'll be back...
 
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