Senior dog with problems

I have a 14 year old cocker/daschund mix that has really deteriorated over the last year. He is somewhat unsteady on his feet at times with his hind legs giving out and also limping. X-rays show some arthritis and I have recently started him on glucosomine/chondroiton He also has slightly elevated liver and kidney values that we are keeping an eye on. The vets wants to do a repeat liver ultrasound in a couple of months. Possibly some testing for Cushings if the liver values continue to rise. He also pants quite a bit. In the meantime he is on milk thistle. He seems disoriented at times just standing and staring and he has started pooping in the house. The vet called in a prescription for selegiline but it went unfilled as it was over $240 for a month's supply! He had a full thyroid panel which was normal. Anything I am missing or something else I should be doing?

Kathy

Has he been evaluated for a slipped disc? These are very common in
long-backed dogs, to include Dachshund mixes.... That Could account for
the rear leg symptoms..... and so could the arthritis.

A ultrasound of the liver is a lot less expensive than a liver biopsy,
and Much less stressful on the dog, as it would require anesthesia....
and anesthesia needs good liver function to clear the drug from the
body.

His changed mental status could be caused by poor liver function, but is
usually seen late in the disease. It can also be caused by
deterioration of cognitive function.... "alzheimer's" which is seen in
some older dogs. Anipryl is sometimes used to treat this.... or attempt
to treat.

Kidney failure in older dogs is progressive. The speed of deterioration
can sometimes be slowed.

But it is time to sit down and give serious thought.... and discussion
with your vet.... about quality of life and comfort.... and to the point
that you are willing to continue to allow this grand old guy to suffer.
And how much money you are willing and able to put into just prolonging
his life.... for your emotional needs. The longer I live with dogs, the
shorter the time I accept for them to continue with an ever
deteriorating quality of life.... that they don't understand.... before
I release them from than suffering.

This summer I had a case of denial about the rapid deterioration of my
17 year old terrier. I should have euthanized him at least 1-2 months
before he died a horrible death a few minutes after I woke in the AM....
gasping for air.... I don't want any of my dogs to suffer just because
it's going to be painful for me to no longer have them in my life. I
hope I would never be so utterly selfish again......

Think about this, and make your decision about when you will say he's
had enough. Then act on it when he reaches that point.

Jo Wolf
Martinez, Georgia, USA

Would normal xrays show a slipped disc? I've had his back and hind end xrayed every year just to stay on top of those kinds of problems. He did have a liver ultrasound about 4 months ago and will have another one sometime after the first of the year. The selegiline as I understand it is the generic form of anlipryl which was cost prohibitive at $240 per month. As for QOL issues believe me I struggle with that question with all my animals. I recently had to have one of my senior cats (15) pts after a short battle with mammary cancer. I had the mass removed for comfort but chose not to do chemo as it is a very aggressive cancer. When she developed a mass in her chest cavity I knew it was time as she was starting to have breathing issues. It was not a peaceful euthanasia like some of the others tho and it left me a little shaken. I'm sure it will be sometime soon with shadow but not yet. Its been a terrible year in our family for several reasons and I just don't have the emotional strength to face his loss this month

Kathy

On 11/28/2012 7:04 PM, wrote:
I have a 14 year old cocker/daschund mix that has really deteriorated over the last year.
He is somewhat unsteady on his feet at times with his hind legs giving
out and also limping.
X-rays show some arthritis and I have recently started him on
glucosomine/chondroiton
He also has slightly elevated liver and kidney values that we are
keeping an eye on.
The vets wants to do a repeat liver ultrasound in a couple of months.
Possibly some testing for Cushings
if the liver values continue to rise. He also pants quite a bit. In
the meantime he is on milk thistle.
He seems disoriented at times just standing and staring and he has
started pooping in the house.
The vet called in a prescription for selegiline but it went unfilled as
it was over $240 for a month's supply
He had a full thyroid panel which was normal. Anything I am missing or
something else I should be doing?

.............I don't see the point of another liver ultrasound - what is
it they're trying to find out? And what could you do about it if you knew?

...........On nutrition front, add extras Bs to food, essential fatty
acids with Vit E. If you feed kibble toss in some real food on top,
meat, eggs, sardines, yogurt.

.............Check www.dogaware.com under arthritis for dosing info on
gluc/chon and other possibilities. I'm adding Boswellia/Curcumen to see
if it helps.

.............I'd do the ACTH stimulation test now. Rules out both
Addison's and Cushings. If you're in tick country get a tick panel.
After that I've think you've covered the bases. I hate these diseases
which are diganosed through exclusion!

.............Try here for Selegiline. I've ordered from this place
before and have a friend who does also. And since my almost 14 yr old
is having a few cognitive issues I think I'll be getting some. No script
necessary and no shipping fees.
http://www.inhousepharmacy.biz/p-593...iline-5mg.aspx

...........If above makes you nervous go here, print out this card and
see if you can get a discount on Anipryl:
http://www.needymeds.org/index.htm

Research I've done on CCD (canine cognitive disorder):
Alpha-lipoic acid:
http://www.umm.edu/altmed/articles/a...oic-000285.htm

http://www.journals.elsevierhealth.c...03765/abstract
Among this population eight dogs affected by CDS were enrolled for the
second step of the project, an open-label clinical pilot trial with the
neuroprotective nutraceutical Senilife®. Senilife® contains 25 mg
phosphatidylserine, 50 mg of standardized Ginkgo biloba extract, 33.5
mg/d-alpha tocopherol and 20.5 mg pyridoxine per capsule and is dosed at
one capsule per 5 kg body weight.

(Note - above specialized drug is apt to be expensive. You can these
separately on your own.)

http://www.veterinarypartner.com/Con...&EVetID=228974

http://www.marvistavet.com/html/body_anipryl.html

MCT med chain triglyc (coconut oil) can be used for Alzheimer’s and
gallbladder disease
Improves cognitive function in dogs:
http://www.ncbi.nlm.nih.gov/pubmed/20141643


Phosphatidylserine used in dogs for Cushings and cognitive function
http://www.sciencedirect.com/science...58787807002195

......................My dog is thunderstorm/fireworks phobic. While DAP
doesn't solve noise issue entirely, I've been trying it for her
pacing/panting issues at night. Takes a couple of sprays to finally get
her down to sleep. From the research I've read, it seems that if DAP
works Selegiline ought to but I need to reread to verify as I'm brain
dead. But it can take from 1-3 months to work. I need to sleep before
then! So I'm using DAP for now when I figure she's had enough exercise!
Seems the sooner you cut off that repetitive behavior, the better.
The longer it goes on, the harder it is to stop. One time I let her
pace and I swear she didn't stop for 12 hours.

Prolactin:
https://www.google.com/search?q=meas...ient=firefox-a

http://www.goodnewsforpets.com/petwo...conference.htm
Prolactin is a hormone associated with feeling nurtured and secure, and
it may also assist immune function. When spending time with their own
dog, the prolactin level increased the most in people, although
prolactin always increased in the presence of a dog. Prolactin levels
generally went down when the subject hung out with the robotic dog. In
dogs, their prolactin levels also increased when they were being petted.
http://skeptvet.com/Blog/2010/09/doe...aving-surgery/
Prolactin is a hormone usually associated with nursing, as it is
released in response to suckling and is involved in stimulating the
release of milk. It does have some other behavioral affects associated
with reproduction and maternal care behaviors, but its significance in
terms of stress or pain is not clear. Some changes in blood levels have
been associated with stressors such as surgery or with the presence of
behavioral problems, such as anxiety disorders, but the role of
prolactin in behavior and stress is not well characterized.

http://www.dog-health-guide.org/anxi...ptomindog.html
Two types of drugs are usually prescribed; psychotropic drugs and
pheromones. Drugs tend to work by either changing the levels of
serotonin (SSRIs clomipramine and the on-coming fluoxetine) or by
affecting the levels of dopaminergic activity (dopamine controls the way
neurons in the brain speak to each other).
The drug chosen will be based on the level of prolactin (PRL)in the
blood. Anxious dogs showing a normal PRL value are significantly
improved when treated with SSRIs (seratonin) when those showing a high
PRL value are much sensitive to selegiline and worsened when treated
with fluoxetine.
The pheromones DAP in dogs has helped in conjunction with therapy to
change behavior such as changing the dog's environment, training and
approaches that encourage relaxation

http://www.journals.elsevierhealth.c...03790/abstract
Abstract
Defining objective, reproducible and standardized parameters for the
evaluation of patients is one of the main academic focuses of veterinary
behaviour medicine. Prolactin, a peptidic neurohormone and a cytokine,
whose main regulator is dopamine, seems to be of particular interest in
relation to chronically distressed patients. The aim of this clinical
study was to assess the correlation between prolactin levels in the
blood (prolactinaemia) and chronic anxiety and to evaluate its value in
helping to guide the choice of the most appropriate drug in dogs
displaying emotional disorders. The inclusion criteria included an EDED
score superior or equal to 10 and the absence of any previous treatment
or physical condition, which could modify prolactin secretion or
emotional reactions. After inclusion, a randomization number was
assigned to the dog, with a preselected treatment: fluoxetine (1 mg/kg
once a day) or selegiline (0.5 mg/kg once a day). Each dog was evaluated
with a complete behaviour examination, a physical examination, EDED
score and a blood sample to measure prolactinaemia.
The dogs were re-evaluated 4 weeks, 8 weeks and 16 weeks later. The
follow-up visits were organised the same way as the inclusion visit,
including EDED scoring and prolactinaemia evaluation.
A population of 84 dogs was enrolled in study. The analysis of the
correlations between prolactinaemia and EDED score show a positive
significant correlation.
Evaluation of treatment follow up showed a statistically significantly
greater improvement with selegiline in the dogs with higher levels of
prolactinaemia compared to those with lower levels of prolactin, who
were significantly more improved by fluoxetine.

http://en.wikipedia.org/wiki/Prolactin

http://veterinarycalendar.dvm360.com....jsp?id=587122

https://www.thieme-connect.de/ejourn...07-1012383.pdf

Regulation of Prolactin Secretion in Canine Pituitary-Dependent
Hyperadrenocorticism
R. Stolp1, M. M. Bevers2, A. Rijnberk1, R. J. M. Croughs3, G. R. Rutteman1

Canine cognitive dysfunction:
http://www.veterinarypracticenews.co...-ease-cds.aspx

SAMe, Ginkgo, Phosphatidylserine

Anipryl:
http://www.drugs.com/vet/anipryl-tablets.html

Cds (cognitive disorder)
The recommended dosage for oral administration for the control of
clinical signs associated with CDS is 0.5-1.0 mg/kg once daily,
preferably administered in the morning. Initially, dogs should be dosed
to the nearest whole tablet. Adjustments should then be made based on
response and tolerance to the drug.

Good luck to both of us!
buglady
take out the dog before replying

On 11/29/2012 6:48 AM, buglady wrote:

.............Ok one more thing. You might try L-theanine (SunTheanine).
If it doesn't work for dog, may help you! Last night I used 1/2 cap,
had given alpha-lipoic acid with dinner and used DAP. Don't know what
finally did the trick but she slept all night.

........It's not really a sedative but just takes some of the anxiety out
of your system.

buglady
take out the dog before replying

Thanks for all the great links! (And suggestions) Looks like I have some reading to do I'm not sure why the second liver ultrasound. Maybe to rule out a tumor? As for the selegiline I almost think she made a mistake in the dosing as it is written for 3x times a day and from what I've read it is usually given once a day preferably in the morning.

Kathy

On 11/30/2012 5:43 AM, wrote:
Thanks for all the great links! (And suggestions) Looks like I have some reading to do

I'm not sure why the second liver ultrasound. Maybe to rule out a tumor?
...........before wasting money, I'd ask for a list of stuff they could
find and what they'd do about it. Would they really do anything about a
tumor? I suppose if it was isolated to one lobe they could, otherwise,
doubt it. Liver is a secondary place for distant metastases in cancer.

As for the selegiline I almost think she made a mistake in the dosing
as it
is written for 3x times a day and from what I've read it is usually
given once a day preferably in the morning.

................No that doesn't sound right! The drugs.com has the sheet
for Anipryl.

..........Don't know where you are but my vet said today that there's
generic Selegiline and it's supposedly cheaper than the inhousepharmacy
at Walmart. We'll see. After I got home I called back and asked if I'd
need a script, but he didn't call back and they close at noon. Grrrrrrrrrr.

buglady
take out the dog before replying

Seligiline will be a prescripiton drug. Generic availability doesn't
mean it changed category.... just that it's cheaper. Some
people/animals won't get results that are as good with a generic; just
have to try it.

Jo Wolf
Martinez, Georgia, USA

The second ultrasound MAY be to follow visible liver damage/tissue
death, not just tumor. Might change management to something more high
power than milk thistle alone.....

Jo Wolf
Martinez, Georgia, USA

On 11/30/2012 4:56 PM, Jo Wolf wrote:
The second ultrasound MAY be to follow visible liver damage/tissue
death, not just tumor. Might change management to something more high
power than milk thistle alone.....

..............Like what SAMe? One could try that now. Really, don't see
the point.

buglady
take out the dog before replying