Gabapentin and Platinum Stamina?

[Paul Schumacher]

Orthopod vet just saw Zoë. Says no cruciate tear, but instead a lower back issue. She is recommending the above mentioned med and supplement for her. Anyone have experience with these?

Are these good quality things?

[Karen, Jasper and Jackdoodle]

It's Gabapentin, and it's a pretty heavy-duty drug, used in humans for nerve pain and to prevent seizures. It was prescribed for JD before his MRI, when they thought he had spondylosis, (the MRI revealed a ruptured disc) and he did not do well on it at all. It caused his whole hind end to collapse randomly when we were out walking; he also fell a lot when trying to run. We discontinued it. My neighbor across the street was taking it for symptoms related to chemotherapy and radiation for cancer treatment.

I'll have to look up the other name you mentioned, it sounds like a supplement. 

This vet cannot possibly know what is wrong with Zoe without doing an MRI. Soft tissue injuries don't show up on Xrays. There are all kinds of "back issues", and I found out the hard way that you don't give medication without knowing exactly what you're treating. What tests were run?  

[Karen, Jasper and Jackdoodle]

Well, the Platinum Stamina, IS a supplement, and a pretty bogus one at that. I'm very familiar with the ingredients as I was a strength and conditioning specialist, and this is similar to some of the products sold to bodybuilders. The only thing in this product that would be helpful for Zoe, might be the L-glutamine, and there isn't enough of it in this product to do any good, only 110 mg. JD takes an L-Glutamine supplement containing 750 mg. 

http://www.platinumperformance.com/Canine-Platinum-Stamina/producti...

[Paul Schumacher]

Thanks for all this info, Karen.  So now I wonder if I should trust anything this vet said...

[Karen, Jasper and Jackdoodle]

I think you have to ask questions, in all veterinary situations. What kind of back issue? How can we be sure this is what she has? Are there tests that can be run? What are the treatment options? What does this drug do and how will it help Zoe? What are the side-effects? What is in this supplement, and how will that help Zoe? Is there anything else we can try? 

The specialist who treated JD did say the only way to know what was wrong was to do an MRI, which requires general anesthetic and is very costly. We did an ultrasound, which showed the location of the problem but not exactly what it was. He suggested we try the Gabapentin, and when we had bad results, he again suggested an MRI, and we got an exact diagnosis. I was then given treatment options, which included surgery or conservative therapeutic options which would hopefully ease his pain and help his mobility but would not cure anything. We opted for the latter, due to other existing diseases which make surgery even more complicated than it would be for a healthy dog.

But the point is, you need more information. It's not a matter of trust so much as not having enough info. 

[Paul Schumacher]

Thank you.

According to this vet:

• she is suffering from lumbosacral disease.  
• surgery is an option if she is suffering from a bulging disc, if conservative treatment isn't enough, or if there is instability/weakness later in life
• she is suffering from a nerve impingement which limits her hips and is what was causing her to favor one leg or the other (when Zoe stands, usually one back leg is a couple inches further back than the other, though it varies which side) Worth noting that before the injury she always tended to stand with one leg a little more forward than the other (sometimes left, sometimes right). 
• she is in a lot of pain

Now my skepticism: the day after her fall 2 weeks ago, she was back to acting completely normal (and has ever since).  The biggest challenge has been keeping her quiet as she wants to run and jump and play all the time.  She isn't acting any different and her movement when she walks, sits and lays down is all comparable to how she was before her spill.  No limping, not slow to rise etc.  I am playing devil's advocate now.  I certainly want what's best for my dog.  However, there is clearly a conflict of interest here as this orthopod is also the owner of the rehab place so I recognize the more rehab, supplements and treatment we get, the more money it is for her.  My biggest question mark comes from her telling me my dog is clearly in a lot of pain.  I've spent almost all day, every day with Zoe, and I see no signs she is in pain.  All of my googling leads me to believe lumbosacral disease would be rare to show itself in a 9 month old puppy.  The one clinical sign that she did exhibit was she went from standing to sitting when the vet pushed on her lower back.  However, she also will do this if I'm trying to get her to sit and remind her but just lightly pushing on her butt.  So I'm not sure if her reaction was from pain or because this is what she does anyway.

[Karen, Jasper and Jackdoodle]

My problem here is with these words: "... if she is suffering from a bulging disc..." 

Again, if you don't know for sure whether or not the disc is bulging, herniated, or ruptured, how can you know that there is nerve impingement, and how can you treat it properly? 

The conservative treatments do add up, and they go on for months if not years. You can surpass the cost of the surgery within a year or two of conservative treatment, so it is definitely not cheaper to go that route. JD's laser therapy cost $90/week for the first 8 weeks after diagnosis, then $60/wk for a period of time, then $30/wk and we are now at $30 every two weeks almost two years later. His acupuncture and chiropractic cost $105/month. The surgery cost would have been around $6000, so you do the math, lol. 

If this were my dog, I would have an MRI done so that I could be sure of what's going on and be able to choose a treatment option with more assurance.

Regarding pain, though, most dogs are experts at hiding it. It's an old, old instinct that runs deep, because to be in pain made you a victim of predators, and put your entire pack at risk. You can never really rely on your dog letting you know how much something hurts her.

[Robin and Libby Louise]

Paul - Libby started limping a few months back.  To make a long story short, after a few inconclusive vet visits, we finally saw her regular vet (sometimes it takes awhile to see him and if it's an "emergency" we will see whoever is available) - he diagnosed a lower back sprain.  Also did the pushing on her lower back and we could immediately see that she was sensitive when he did it, albeit slightly.  Said she should lose 5 pounds and to give her glucosamine & chondroiten, and gave us Tramadol if she seemed to be in pain.  I know the jury is out on that particular supplement, but she did lose the weight and the limp is gone.  We never needed the Tramadol.  Of course he did say that if the limp persisted we would need to do further tests.  Also, Libby is 7 and you have a baby, so a vet might choose a different course of action for one so young.  But you need to be satisfied and secure in what your vet says and does.  If you think there might be a conflict of interest, go to another vet to give yourself peace of mind.

[Paul Schumacher]

Thanks, Robin.  We returned to our vet today for a followup and she confirmed her original diagnosis of a partial cruciate tear.  Because Zoe was so quick to be back to normal (1 day) without a limp and with no signs of pain or changes in habits, activity or gait, we are hoping the tear is small.  There is still some laxity in the joint and likely some fluid, but we are going to continue being conservative with her care and hope to slowly ease her back into more activity in the next 4 weeks.  

Thank you all for the comments/sharing your own info.  I hope this is the last time we are posting about this!