Guidance on managing spinal bone spurs

[jglonek]

Hi everyone,

It's been a long time since I've posted about Raina. She just turned 10 on Sunday! You can read about her previous issues with growth deformities in her front feet here: 

 

The summary to that is, she had four surgeries between 2013 and 2017, two on each front foot, to correct growth deformities with her front feet. They were straightened with plates, and the wrists fused. It was a lot of recovery time, but I have no regrets doing it, I think it was worth it. We worked with Dr. Hay at Veterinary Surgical Specialists in Tampa, FL and I have nothing but good things to say about him.

Unfortunately, Raina has continued to develop health issues.

In the summer of 2017, Raina started vomiting. After several diagnosis and a CT scan, it was determined she has copper hepatopathy, which has been manageable with daily ursodiol pills, and rechecks of her ALT levels several times a year.

In October 2017, when she was 5, she had a FCE embolism in her spine one morning when I was letting her outside. She temporarily lost all movement in her right hind leg. With time and therapy (including cold laser therapy), she regained maybe 80% of the movement. I think we were lucky in that regard, it could have been worse.

All the issues with her legs caused her to have early onset arthritis. I would say by late 2019/early 2020 she was definitely slowing down. 

Which brings us to now. Raina is having trouble getting up from a sitting/laying position, especially when on the couch. Once she is up, most of the time she can get around OK, although there are days (like today) where she is wobbly, and that seems like a side effect of her weak right hind leg from the embolism. The couch is the worst, she basically slides off of it, and sometimes can get her balance and stand right away with her rear legs, other times not. She can still make it outside to go to the bathroom and generally does not have trouble balancing while doing that. I don't know if it hurts, she doesn't really vocalize that it does. Some days she seems uncomfortable and not able to lay in one spot for an extended period of time, moving around the house a lot.

We took her to the vet earlier this month, who looked at previous X-Rays (almost yearly at this point), and said her hips are fine, but she definitely has bone spurs at the base of her spine by her tail. I guess the technical term is spondylosis deformans? We already knew she had those, but I guess it's getting worse.

I know our journey is getting close to the end. I just wanted to make this post to see if there is anything we are missing that we should be doing for her. (I know taking away the couch from her is an option since that seems to be her worst spot, but, she likes it there).

Currently, Raina is on:

9AM - 2 100mg gabapentin, 1 100mg carprofen

7PM - 2 100mg gabapentin, 1/2 250mg ursodiol

We did start her on Adequan injections 6 weeks ago. She was getting Monday/Friday ones for 4 weeks, and now is down to once a week on Friday at 6pm. We did notice an improvement after starting - she can get up on the couch better than before. Getting down, no change. And I'd say the past 24 hours have been back to where we were before we started Adequan, although she might just be having a bad day.

We did try Tramadol at night, but it seemed to knock her out without any noticeable improvement in mobility.

We did order CBD chews from ElleVet that should be here today, and will start that. Adding those in with all the other medications seems like a lot, though. 

If you have any thoughts or suggestions on how to improve her quality of life, or make her comfortable, let me know.

Oh, and here's a picture from her 10th birthday on Sunday!

[Journey]

Kudo's to you for all you've done for her and continue to do! I was under the impression, could be wrong, that once the vertebra fuse, there would not be any more issues wrt to the spondylosis..I've dealt with an FCE, you and she did get lucky in some regards! My old gal lost use of her entire rear. A few years later and she was about 90% but it did take it's toll on her. Where are you with the adequan injections? A loading dose for a few weeks and now maintenance weekly? I did find they did help. You are doing all you can from the sounds of it. Do you have access to an underwater treadmill, or a pool? Swimming helps but we found that walking in chest high water helped more, non impact but made her use herself. Good luck to you and Raina!

[jglonek]

Hi, and thanks! We are trying to make sure we do everything we can to help her out.

That's an interesting thought with the bone spurs. Last month was not the first time they were seen on X-Rays, they were on there at least a year ago (if not more). Today is definitely a "bad day", and at least today when I watch her try to get up and walk, most of the issue seems to be with her right hind leg that had issues from the FCE. She's also tense with it and won't really let me move it. We did originally think it might be her hips/arthritis before we got the new X-Rays last month and the vet said those looked fine. Maybe it is more her leg not working as well anymore, but all her issues combined are certainly a challenge.

Our current vet does not do cold laser therapy, so I scheduled an appointment with another that does for next week. I don't know if another round of that five years after the first will improve the current condition of her leg at all, but I'll feel better if we at least talk to the vet and see. Our vet did just send me information on at-home rehab & therapy (including cold laser therapy) as well.

She has not been back to the specialist that did her surgeries. Unfortunately we moved and they are now about 2 hours away. If this cold laser therapy vet recommends a specialist I will make the drive for them to look at her again.

Yeah, we did 4 weeks of the twice-weekly loading doses for Adequan and last Friday was the first just weekly one we did. We definitely did see improvement - before we started she couldn't get up on the couch at all, she would put her front legs on it and wait for us to do the rest. Now she hops up on it. So that's definitely better. But her getting off the couch, or getting up from sleeping on the floor, seems to be the same if not worse than a month ago. And all definitely worse than a year ago.

I forgot to mention that we did buy a ramp for the couch - she doesn't like it. She used it once or twice to get up and then started jumping on the couch around it. We flattened it out and put a table underneath for her to at least use it as a big step but she's still not interested. And with how she doesn't stand on the couch to get down, and instead just slides off, I don't think she can use the ramp to get down unfortunately. 

We do not have access to an underwater treadmill or pool unfortunately. Although maybe between the vet and the rehab info I was sent some options might open up.

Right now I think the plan is to continue giving her all her meds, and her adequan injection on Friday. Start with the CBD chews at the higher week 1 dose tomorrow, and bring her to the cold laser therapy vet on Tuesday to get their opinion. If there's anything else we are certainly open to ideas.

I just don't know how all this feels to her. If she's in pain constantly or not. I hope we don't have bad days like today all the way to the appointment next week.

Oh, and she is the worst after she has been laying for awhile - especially after laying for an hour, or two, on the couch, in the same position.
 

[urge to herd]

jgjolonek, I had to build a ramp for my Gibbs to get down into the back yard and then up again. It was custom made for him, all the ramps I saw were waaaay to steep for him.  That might be what's going on for your girl.

Some wonderful friends decided they would build one for Gibbs with a much gentler slope and some rubber matting on it so he wouldn't slip. It took a little time and some coaxing, maybe 3 days or so that I lured him up/down it with chicken bits. Since then he's fine with it. He hesitates a bit, but I think that's because of the cataracts he has.

Another thing that might help is if you get her to walk on whatever ramp you use, purchased or custom built, while it's flat and stable. That would get her used to the surface and perhaps more sure of herself.

Good luck!

Ruth & Gibbs

[jglonek]

Hey all - just a quick update.

We started giving Raina the ElleVet CBD chews a week ago and she is actually moving much better. Not like she used to, but definitely better than she was a week ago. Still has trouble with her right leg sometimes, but not her left as much. Didn't expect CBD chews to do that much!

We did bring her to the cold laser therapy vet yesterday. That vet apparently knew the specialist who did all her surgeries and really likes him. And is comfortable with the meds our current vet has her on, doesn't want anything to change. We are going to  do (at least) 5 sessions of cold laser therapy starting next week to see if that helps some too.

[amc]

Good news for Raina!  Thanks for keeping us updated.

Amy

[Journey]

Nice! I think you will see that the CLT really does help. We did daily for 8 weeks and the improvements was substantial. Good luck!

[D'Elle]

Very interesting and I am glad there's something that helps! Keep us informed and best of luck to you and Raina.