MondayMoanday

 We told Mom that our blog needs a new secretary.  We keep saying we are going to do beter and that just doesn't happen.  So today we, Misty and Timber, put our paws down and told HER that we needed to do a post because our big teddy bear brother needs all his pals to send him some good vibes.

 LIghtning's almost 13 years ( May 4th birthday) are taking their toll.  The past few months have brought rapidly increasing difficulty in walking, getting up and down,  and doing stairs.  He has been on a variety of medications for pain, ranging from tramadol, gabapentin, Rimadyl, and those new promising Librela injections.  After four months of the Librela shots, the vet said they were not working for Lightning. Librela is a monoclonal antibody treatment that is supposed to direct the nerve sensors to send a message to the body that there is no pain.  Unfortunately that message doesn't seem to get through to Lightning's joints.  The vet thinks his body may be developing antibodies to the medication.  So he switched Lightning to some anantadine which is supposed to do the same thing as Librela but maybe in a way his body would accept.  It is also used in humans and is one of those drugs that either works or doesn't work. It is still early to tell if it is helping Lightning because other behaviors with him have brought additional changes in his meds.

Because Mom was waking almost every morning to puddles on the kitchen floor where we are confined at night, she decided to put a Ring camera in that area to figure out who the culprit was.  It only took one night of filming to see that it was clearly Lightning.  He was checked for a UTi and had an ultrasound of his bladder and kidneys to see if he had stones or a tumor or something that would explain the urination issue.  He had also previously been tested for Cushing's.  All results were negative.  The camera also revealed another situation.  Lightning does NOT sleep at night.  He is up roaming around (and occasionally peeing) literally every half hour from midnight until 5:30 a.m.  He never barks or cries out; he is just totally unable to settle.  So how to explain THAT!!!

Another vet consultation yielded two possibilities.  One could be a side effect of the gabapentin, which in some cases causes confusion in dogs that mimics doggy dementia or cognitive dysfunction.  The other is the early stage of that dementia.  So Mom stopped the gabapentin last Wednesday.  It may take a week or more to determine if the gabapentin causes the wakefulness.  If it slows down significantly or simply stops, then it is likely the medication.  If it doesn't, then it is likely cognitive dysfunction.  In the latter case, he could go back on the gabapentin and an additional med for the dementia.

Meanwhile our wonderful vet is married to another wonderful vet who has been working in veterinary research for a few years and who has just recently acquired her certification in physical therapy for dogs.  She started working one day a week at our vet's clinic last Friday and guess who her first patient was?  Yep, Lightning!!!  He has a very hard time easing himself down to the floor or to his bed and even more difficulty getting back up.  Stairs are a huge problem.  He has to go down 7 steps to get to the yard.  About 50% of the time he does OK, but then he may start down just fine with his front paws, but his back legs give and he just drags his back end down the stairs. Coming back up the stairs are a challenge as he doesn't have the muscles in his back end to pull himself up.  

Sorry this is getting very long. At his PT visit Friday which lasted about an hour and a half with Mom there, and then another two hours where Mom left him with the vet  to do some more work, Dr. Sarah put him through a thorough neurological exam and determined that his issues are not neurologically related - that is the good news.  But his problems are all muscle and orthopedic issues. She proceeded with the orthopedic exam and made her prediction for where the issues were.  She then proceeded to a full range of x-rays.  We were expecting to find issues with his knees and hips.  You might remember that he had torn both CCLs in 2018 and 2019.  One knee was surgically repaired but his recovery was long and difficult.  That knee never really fully returned to normal.  The decision was made NOT to repair the second tear and let the joint heal as best as possible on its own.  We knew that both knees were highly likely to develop arthritis.  The surprise was that the worst of his pain is coming from his back.  He has severe arthritic indications the entire length of his spine.  No wonder the poor guy is struggling with his mobility. And he NEVER complains.  You can see how important it is going to be to get his pain meds under control

The physical exam also revealed that his front shoulder and upper leg muscles are very tight because he is relying on them for most of his body support.  The hip muscles are also very tight and his range of motion in all four legs is limited.  So Mom came home with a myriad of exercises to do with him daily.  She has videos from the vet to guide her.  Lightning was fairly cooperative today for his therapy session with Mom; she is taking it slow and steady with him.  The hope is to try to get his muscles moving more freely and hope that will help his mobility.  

Between the pain, mobility issues, possible dementia, and general aging, our gentle giant is not doing so well.  He could use a little POTP from his friends.  We know that our peeps will continue to do all they can to help him, but the main goal is getting him to be comfortable.  That is only fair to him.

Sorry for the long and sad post, but maybe it will help explain why we don't get to post much.  Mom says it is hard to find happy moments to share.  It's been a rough few years with lots of family medical issues, both human and canine. We think she just needs to change her mindset:).  

We don't want to make any promises, but we WILL try to find something cheery to tell you about soon.

Woos - Lightning, Misty, and Timber

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