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#1
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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 |
#2
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Senior dog with problems
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 |
#3
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Senior dog with problems
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 |
#4
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Senior dog with problems
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 |
#5
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Senior dog with problems
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 |
#6
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Senior dog with problems
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 |
#7
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Senior dog with problems
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#8
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Senior dog with problems
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 |
#9
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Senior dog with problems
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 |
#10
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Senior dog with problems
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 |
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