Arthritis Cases

Thank you for helping us all out here. I have an eight-year-old who has hip dysplasia and arthritis in both hips. She has been overcompensating and now has arthritis in her elbows as well. We have tried galliprant, green lipped muscles, CBD oil, fish oil, and Tumeric. We keep her activities low impact and have tried swimming, laser therapy, and the Assisi Loop. Do you have any other recommendations that may help her at this point? She has begun head bobbing when walking in the morning so I think it has gotten worse.

Dr. Steve's Advice - to take pressure off the front legs, we need to do something for that pain from hip dysplasia. Even at this advanced stage, I have seen Voltrex (https://goldstandardherbs.com/products...) from Gold Standard Herbs work quickly to significantly improve mobility. It may help the forelimb arthritis as well. 

Then there are all the other things that can dramatically improve hip dysplasia and osteoarthritis:
- a real food meat-and-vegetable diet
- chiropractic
- acupuncture
- physio- or rehabilitation therapy
There there are other things you can do like prolotherapy, stem cell therapy, etc. Bottom line, you've probably barely scratched the surface here. Start with diet change and Voltrex and then see what else is at hand to add in next. I'm sure you can get your dog feeling a LOT better

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I was wondering if a lack of space between joints indicates arthritis? We sent his xrays out to radiology. The fact that they didn't mention the bone spur tells me they didn't think it was significant. I'd like a second opinion on the lack of space between the metatarsal (sp) and the first (index finger/toe) filange (sp) and the bone spur. He broke the first digit a few years ago but I was told it wasn't a serious break.

Dr. Steve's Advice - if the pain is related to an old fracture, then homeopathic Symphytum (30C strength) given twice daily for a few weeks may resolve it.

Since NSAIDs were helpful and the pain stems from the paw, Quick River by Kan Essentials (often available on Amazon in the US) may resolve it as well. Dose according to the chart at https://nphc.ca/using/dosage. Give the number you see there twice daily.

Hopefully that helps you out. If you're just not sure, you can given both things together. Also have a chiropractor check your dog's neck. An amazing number of forelimb lamenesses in dogs actually come from neck fixations.

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Kaiser, 8.7 years old had his yearly physical last week.  Going into that appointment he was being treated for arthritis with Deramaxx 75mg per day. Yesterday our veterinarians office called to report that his liver levels were high, which could be caused by the Deramaxx. They suggested lowering that dosage and add Denmarin to help his liver recover. My question to you all is first and foremost for any insight you may have into this. Also do you know of anything I can add to his diet to help his liver as  well.  Kaiser and I appreciate your input!

Dr. Steve's Advice - if you have to use NSAIDs to keep your dog comfortable, you can try add in something that will improve liver blood circulation. Denamarin is not likely to help in that regard. I would suggest something like Happy Wanderer from Kan Essentials, which you can source safely through Aleksandra Topic at aleks.topic1@gmail.com. Hopefully that will help.

If it does help a little, circle back. There are herbs you can use along with it that might help with the arthritis. For sure you should only use the drug if your dog needs it. If he's not painful, give him a day off like you would for yourself.

Lastly, look around for canine physio or rehab therapists, chirorpactors or acupuncturists. Sometimes their methods are more curative, allowing a reduced reliance on the drug.

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I'm wondering what you would suggest for a Golden Retriever with really severe arthritis in her ankles. She does have chiropractic adjustments and laser. But the vet doing it hasn't really focused on her ankles. You can literally hear them creaking when she walks. She has good days but the bad days are bad. She has a sensitive stomach as well so if she has a GI upset the increase in potty trips really takes a toll on her getting up and down. She's been weak in her back end since she was a puppy (I'm assuming that's why the breeder sent her to a rescue) and we though it was always just weak hips. Now I wonder if it's always been her ankles. She is currently in CBD. She has been off of her Yumove and omegas for a few weeks because she had a GI episode and hasn't been out back on them yet.  She also is on Kan herbs Benefit hip and knees. We tried the Voltrex but getting the powder in her is impossible. She won't eat it on her food. 

Dr. Steve's Advice -  for a sensitive GI and very swollen (fluid-filled?) joints, the first thing I think of is Free the Sinews by Kan Essentials. You can get an authentic version from Aleksandra Topic at aleks.topic1@gmail.com. Find her weight in the table at https://nphc.ca/using/dosage and give that amount twice a day. It might also help those weak hind legs

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Can a Cushing's dog be given Lumbrex? She is a 10 year old boxer with pituitary Cushing's (with a macroadenoma) and had SRT done over 2 years ago. She also has very bad arthritis and has been whimpering more recently. We have been giving gabapentin 100mg 2x a day and know we can increase that but I'd prefer to give less drugs, not more. Her Cushing's is controlled with vetoryl but we only give 10mg every few days. We also give CBD 10:1 with THC as needed for pain. I was on the Gold Standard website ordering Cessorex and saw the Lumbrex and thought it might help. Any recommendations are appreciated! I hope you have a fabulous 2023!

Dr. Steve's Advice - If your dog has actual arthritis in the hips or knees, I'd wonder about Gold Standard Herbs' Voltrex (https://goldstandardherbs.com/products...) as a better fit. If the joints are severely puffy and swollen at all, such as in polyarthritis, then I'd wonder about a Kan Essentials product called Free the Sinews. If you meant the arthritis was in her back, not her legs, then Lumbrex is a good fit if both legs are somewhat equally affected and she is primarily weak and not so much lame. If the response to Gabapentin has been dramatic, that is another reason to try Lumbrex.

Some people just use Voltrex and Lumbrex together to hedge their bets! Hope that helps!

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What do you think of this product or Myos muscle formula for improving muscles after TPlO ? This is for my 103lb male lab mix 2 2/3,yr old brindle. Who has had 2 modified TPlO surgeries due to deformities. 1 in May and 1 end August.

His name is Dakota he takes yumove right now )will switch to Dasaquin advanced until I find a better joint supplement ).He is eating honest kitchen in pm and will be eating Natures logic Distinction or honest kitchen clusters in pm. 

Other pup is Sandy she is a 2 years old female black mouth cur who has same diet and supplement as Dakota. She weighs 70 lbs. and has had limping and hopping on z3 legs off and on . Vet suspects possible partial cruciate tear. Wanted me to do X-rays at cost of $558 pd $80 for exam. surgeon who did Dakota wants $180 for exam says xray not necessary. I am going to follow your natural steps for healing but wondering if she needs additional supplements also. Thank you for your time and help sorry thi is so long. Really appreciate you and your advice.

Dr. Steve's Advice - either of those products is fine to try and not likely to cause issues.

To my mind, medicine is like a game of darts. There are a lot of ways to rack up points, but you only need one dart in the bullseye to win the game. Glucosamine, chondroitin, and Myos are like 'point racker uppers' whereas something like Voltrex (https://goldstandardherbs.com/products...) by Gold Standard Herbsis something that hits the bullseye. The reason it hits the bullseye is because it does so many things despite being a relatively simple product. As discussed in Sarah MacKeigan's webinar with Sarah MacKeigan: Upward DOG: Rehab & Wellness the other day, it:
- targets the microbiome and its role in arthritis
- normalizes circulation through the joints and ligaments, to stop renewal of inflammatory responses and allow healing to occur
- quells the inflammation already present in the joint
I think that's why it works so quickly and completely. It also takes care of the main differential diagnosis for cruciate tears, which is sciatica from sacro-iliac fixations. That needs to be ruled out in Sandy and can't be detected on an X-ray. A visit to a chirorpactor or rehab therapist might help make sure it isn't there, or provide prompt relief if it is.

As for Daktoa, even though the problem has been ostensibly corrected through two TPLOs, it hasn't been from a Chinese medical point of view. The underlying diagnosis of Shao Yang disharmony still exists. The continued presence of that disorder, which amounts to a blockage of adequate blood flow to the hind limbs, is what (in their eyes) is keeping the muscles from getting the circulation they need to become strong again. Thus, even with the surgeries and the products you're considering, I'd still use Voltrex for him, too, to be more assured of reversing that atrophy. A visit to a chiropractor/rehab therapist might also make sure there are no spinal fixations impeding nerve impulses to the legs that can make the muscles become weak

My last comment has to do with diet. I see you're trying to move along the continuum from processed to real food. Dehydrated foods are still substantially processed, though. Strive to give as much real food as possible, since it is lower in AGEs and inflammatory effects, and since real food normalizes circulation through joints and ligaments whereas dried processed foods really do not

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My very spunky 13 yr old Prada had an acute back/spinal cord injury friday. 

She has arthritis in her back but was not on any type of meds for it as she was seemingly moving around very well! 

Friday something happened with my other dog and her and she lost feeling/movement in her back legs. Went to the ER, she was very shocky at first but they were able to stabilize her. Xrays were negative for fracture. 

At first she needed to have her bladder expressed but now she periodically go on her own and has anal tone but no use of back legs. 

I am cautiously hopeful that this is just severe inflammation but a spinal cord injury cannot be ruled out. 

She is home and comfortable on codeine, gabapentin and galliprant. 

What else can I do to help Prada?

Dr. Steve's Advice - I would start with Voltrex (https://goldstandardherbs.com/products?store-page=Voltrex-85g-p487930445()) from Gold Standard Herbs, if the hind limbs aren't moving much. It's anti-inflammatory for arthritis but also is my first choice for reducing acute spinal cord trauma enough that the nervous system senses it's safe to move the legs without risking further injury. 

Once you're seeing obvious purposeful movement and your dog is well on its way, consider Lumbrex from the same company to help actively resolve the inflammation and arthritis in the back, while reducing the likelihood of future disc rupture and acute spinal injury. 

Along with that, consider using a real fresh food diet instead of canned, kibble, or other processed foods. It's very rare for dogs to suffer repetitive spinal injury on real (cooked or raw) diets

Lastly, consider a regular visit to a doggy chiropractor to help keep the spine supple, which will help fully resolve the current episode and to help prevent future ones from happening.

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Hello Dr. Steve.
My 16-17ish year old rescue beagle Juno has stage 4 kidney failure, mild cognitive problems, anemia with back leg weakness, and severe arthritis.
Through a whole food diet, high quality supplements and vitamins, and no vaccines if been able to keep her with me for longer that the vets thought.
I have an appointment for Tuesday to put her to sleep because she’s having difficulty walking and getting up on her own. I started Ferrum metallicum yesterday after reading a post here on your recommendation for anemia. I’m not sure if it’s my imagination but she’s less wobbly today. How long do I give the Ferrum metallicum to work? I’ve been giving 2 30c pellets every few hours.
The kidney failure is mostly under control at this point. She’s incontinent and very underweight (vet said from ckd and anemia) but has been eating really well recently. I’ve been giving her beef liver and kidney with green beans, spinach, sweet potato, and whole grain oats for some extra calories. She also gets raw goats milk.
I’d give just about anything for more time with Juno.
Here’s what I give her in addition to the Ferrum metallicum.
Myos canine muscle formula
Adored beast healthy guy
Kidney support gold
Dr Harvery kidney health
Dr Mercola ubiquinol
Ginkgo biloba 30 mg 1x a day
Phos bind
Adored beast liver tonic
Nordic naturals omega 3
Ellevet cbd 1 - 6mg soft gel (makes her sleepy so only at night)
Melatonin 1 mg before bed
Is there anything else I haven’t tried? 

The weakness and cognition are the reasons for considering putting her to sleep. She’s still a love and I believe still knows who I am. 

Thank you.

Dr. Steve's Advice  -  It seems you've been doing a really good job with your little guy. I would look at introducing Rehmannia Eight from Kan Veterinary Essentials and use the dose recommendations found at https://nphc.ca/using/dosage. Rehmannia Eight has been shown in studies to restore renal blood flow, improve blood work, improve urine concentration, raise the RBC count (like Ferrum is doing) and enhance cognition.

Failing that, you should at least triple the dose of the Dr. Harvey's product, as long as it doesn't cause any loose stools or anything. The single herb Rehmannia, but not the other seven herbs that make up Rehmannia Eight, are in the Dr. Harvey's product, but the current dose may simply not be enough to make any difference. Rehmannia Eight is designed to allow big doses of Rehmannia to be used without any side effects and also contains plants that interact synergistically with it to improve older animals' continence, hind limb strength, cognition and urine concentration.

As for the Ferrum, I would keep going with it. You might a find a couple of weeks on the above regimen (including the Ferrum) really improves your dog. If you see improvements, another thing you can do is add a formula called Three Seeds Combination.

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Hi Dr. Steve,

I started my dog on Voltrex, but wanted to check with you and see if you knew if it was safe to use with urate stones? Also any other supplements or treatments you recommend for arthritis and hip dysplasia? Thank you  

Dr. Steve's Advice -  there are many other supplements you can use, which is both good and bad news! Voltrex (https://goldstandardherbs.com/products...) is an excellent place to start though for managing hip and knee osteoarthritis, together with a real food diet. See how that goes and then circle back to describe any lingering concerns. Based on that, I can suggest what to add in next! 

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My senior GSD is having trouble getting up these stairs some days.  Not all. Some days.  Sometimes she won’t come to the kitchen to eat breakfast. And she stays in my room for hours.  And sometimes she will stay in here rather than be with the family.  Due to the steps.   She has arthritis and hip dysplasia.   I often have to help her get in the car if I don’t have her ramp.   Now she also runs and plays with puppies at the park.  Acting like a puppy herself. And pays for it later. or swims at Fieata Island and is down for the count. Of course I’ll take her to a vet.   Is it safe to double up or go 1.5 on either of these drugs when she’s having rough / painful and really stiff days? Her rescue organization vet is not very responsive when I ask. And will only give  info to the woman who owned the rescue and not “foster dog moms”. (This is a foster dog). I want to avoid her being in pain.   I thought if I knew what to ask for. And what blood work she might need.  I could get action from the vet.   Or take her to another vet and get an answer. 

Dr. Steve's Advice -  I can't really tell you to take more of the drugs than the vet recommends. My preference is to use herbs.

Laura Oliver runs a senior dog rescue called Lionel's Legacy in San Diego. She uses Voltrex followed by Lumbrex (both made by Gold Standard Herbsat https://goldstandardherbs.com/products) to deal with dogs like yours, who have both joint pain and weakness. You may want to give them a try. If we are lucky, Laura may weigh in with her experiences here so you're not just taking my word for it. They are safe to use with the drugs you're using and will probably allow you to eventually use lower doses.

Hope that helps!

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Hi Dr Steve. My 14 year old baby girl Jazzy has had both her knees done. Her first one (left) thanks to a luxating Patella was done when she was just 18 months of age. Her second one was her right knee she smashed her ACL and her Patella In 2015 playing chasie with her brother at the park. Then In April 2016 she had to have her right knee opened up again as the line our Vet used snapped on her. Can you recommend anything for us to help her with her Arthritis ??? We currently have her on Sasha's Blend . We would prefer to keep her on anything other then tablets If we can help It. She's very difficult to give tablets to !!! 

Dr. Steve's Advice -  had a similar case named Milo which my wife, and I treated. He had bilateral knee issues due to luxating patellas and some failed surgeries. There are a number of herbal medical possibilities, but the most important thing that set Milo's healing wheels in motion was chiropractic and acupuncture. A lot of knee issues in dogs are actually due to low back fixations, which chiropractic can quickly address. This is especially true for luxating patella tendencies but should be considered for any weakness. Basically, when you have weak knees, you can compensate for them using other muscles higher up the legs. These muscles need normal low back motion to work properly. If the low back starts to seize up, the ability to compensate for bad knees vanishes, and you suddenly become aware of the problem. See if you can find someone to check and adjust your dog's low back. After just one or two treatments, the improvements are usually pretty significant, especially if acupuncture is also being done. Hope this helps you out!

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 Hi Dr. Steve! Needing help for my sweet, 10 year old lab mix. He began favoring his hind right leg in April of this year. I started him on glucosamine supplements and that seemed to help. He was no longer favoring his leg. Fast forward to the end of June and he suddenly stopped using his leg all together. So we went to the vet and got X-rays (first picture). They diagnosed him with arthritis and degenerative joint disease. They gave him carprofen and gabapentin, which offered him no relief. 2 weeks ago his leg just seemed to swell significantly. So back to the vet we went. They took X-rays again (2nd picture with obvious swelling) and the radiologist said it was bone cancer, though there was a small chance it could be an infection. His bloodwork was normal with the exception of a slightly elevated liver enzyme (the normal range was 131 and his was 133) and high white blood cell count. They gave him baytril and pain medications. His leg is warm to the touch. We haven’t seen much difference in the swelling and he has been on his antibiotics x 12 days. They have said we can do a bone biopsy but we can not get him in to the specialist for atleast 3 weeks. 

I’m not sure if this could be related. We did rescue a pup who turned out to be Parvo positive. She was briefly around him (1 hour) so he did get a vaccine booster just to be safe about 3 weeks ago. 

I am wondering if the high white blood cell count can be d/t infection, or is there a possibility that it can be as a result of bone cancer? He is going back Wednesday for follow up X-rays. Is there a different antibiotic that could be tried instead of baytril? I did find some information on Olive leaf powder and turmeric to help with the infection and swelling. Is this something you would recommend? I am trying to help my boy, but we do not have unlimited finances . Any advice would be so so appreciated!

Dr. Steve's Advice -   that looks pretty nasty. The entire proximal femur looks like it is starting to disintegrate. Such severe inflammation seems like it could raise the WBC regardless of cause, and is more characteristic of bone cancer. I would have thought Clavamox a better antibiotic to try to rule out infection, but if there hasn't been any improvement on antibiotics at all, then it suggests a tumor is more likely. Amputation is well tolerated, is sometimes curative, and would make him instantly more comfortable. If high doses of Clavamox don't help, I think you're looking at that as the next step 

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My dog was recently diagnosed with Spondylosis, IVDD & severe arthritis. 

We are currently doing chiropractic adjustments, frequency therapy & we have our first acupuncture treatment tomorrow. 

I was recommended Lumbrex from another group, would this be a good option for him? Does it have any drug interactions? He is on other joint supplements & a low dose of Rimadyl. 

Thank you!

Dr. Steve's Advice -  it's a great choice. Lumbrex won't adversely interact with any medications and is safe to try. If he does well, you might want to see if the Rimadyl is needed any more, since it can interfere with circulation to the spine, and that's what you need to mitigate those various pathologies you have there. I'm glad you have those physical therapies in place, too. I'm guessing your dog will rapidly improve 

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Hi Dr. Steve,

Thank you for helping us all out here. I have an eight-year-old who has hip dysplasia and arthritis in both hips. She has been overcompensating and now has arthritis in her elbows as well. We have tried galliprant, green lipped muscles, CBD oil, fish oil, and Tumeric. We keep her activities low impact and have tried swimming, laser therapy, and the Assisi Loop. Do you have any other recommendations that may help her at this point? She has begun head bobbing when walking in the morning so I think it has gotten worse.

Dr. Steve's Advice -  to take pressure off the front legs, we need to do something for that pain from hip dysplasia. Even at this advanced stage, I have seen Voltrex (https://goldstandardherbs.com/products...) from Gold Standard Herbs work quickly to significantly improve mobility. It may help the forelimb arthritis as well.
Then there are all the other things that can dramatically improve hip dysplasia and osteoarthritis:
- a real food meat-and-vegetable diet
- chiropractic
- acupuncture
- physio- or rehabilitation therapy
There there are other things you can do like prolotherapy, stem cell therapy, etc. Bottom line, you've probably barely scratched the surface here. Start with diet change and Voltrex and then see what else is at hand to add in next. I'm sure you can get your dog feeling a LOT better

Click here to read the whole thread.

Hi Dr. Steve, I was wondering if you had any suggestions on what I can do to help my 120lb 9 year old Akita, Thor, whom I think is developing arthritis or some kind of pain due to aging; when he gets up off the floor after laying down for a while his joints pop a lot so I think he could use something for joint lubrucation as well. He is very healthy for his age other than being slightly overweight but if I could help him be more comfortable then I think he would exercise more and lose the weight, I’m just not a big fan of pharmaceuticals unless I have no other options. Thank you and have a Happy New Year! 

Dr. Steve's Advice -  joint popping per se is not an indication for drug therapy, as long as there is no associated lameness. The weight may be having an impact on that, though.

The single easiest way to get a dog to lose weight and reduce any predisposition to chronic arthritis is to feed real food. Any meat-and-vegetable non-canned or -kibble diet is fair game. You can make it yourself, buy refrigerated cooked foods, or buy raw foods. So many right answers there.

Note that half measures tends not to work, such as simply putting some real food on top of the kibble. Kibble always sets in motion certain metabolic tendencies that promote fat deposition and promote an easy tendency to inflammation. It's inescapable.

Even a few weeks on real food should make a palpable difference in your dog's energy and weight. I'd seriously consider finding a real food diet solution that works for you and your pocket book.

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I know this topic has come up before, but I'd like to ask based on my dog's specific circumstance. Two days ago, he completely tore his cruciate ligament in the back right leg. He is an almost 9-year-old 100lb giant schnauzer who was neutered too early and has severe arthritis in the other limbs. he is not weight-bearing whatsoever on that injured leg. He is given an arsenal of supplements for his arthritis, including broad-spectrum hemp seed oil, homemade turmeric golden paste, fish oil with vitamin E, joint pills, daily Carprovet for inflammation, and is fed a balanced raw diet. To manage pain since the tear He is now on 600 mg of gabapentin twice a day. The vet says his left hind leg, the one that's not injured, looks "OK". 

Is he a candidate for surgery? The specialist who x-rayed him is not available to do surgery until late July. What are my best options here? Thank you so much for any guidance, I appreciate it!

Dr. Steve's Advice -  

if you can't get the surgery done any time soon, then my advice doesn't really change. You might as well see if you can start the healing process in the interim. You have hopefully read all about what I recommend for that. Chief among them are:
- Voltrex (https://goldstandardherbs.com/products...) from Gold Standard Herbs
- physical therapies like chiropractic to help make sure there are no nerve impingements to the musculature, so they can stabilize the knee as much as possible, while ruling out other look-alike problems like sciatica from piriformis syndrome
Unless the knee is incredibly loose and sloppy, there is a chance it can heal. As for the status of the other ligament, it is impossible to say. Three days ago, your vet would have said the current ligament was fine! Getting forces in play that can heal the ligament is thus an excellent idea, if only to help stop the other one from rupturing.
So far as whether the surgery can be done safely, that is something for your vets to decide. If there are no heart issues or concerns on his blood work, then he would seem a good candidate for surgery in the absence of any thing else going on.
Here's hoping this advice helps!

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Hi Dr Steve 

Hoping you can provide some insight.  My 10-12 year old shelter pug has 2 things going on.  My biggest concern is the anemia.  He presented with inflammation around his front elbow/ chest area before Thanksgiving.  Had X-rays and biopsy, dx: arthritis.  Treated with galliprant a few times a week.  Swelling increases when it’s cold and damp out.   Before Christmas he started showing signs of GERD: dry retching, retching with foam/ mucus, and undigested food or water if he just ate or drank.  This week he stopped eating.  Went to vet yesterday and labs are terrible.  Due to his age, and cost, we probably won’t do a transfusion.  He was given IM dexa yesterday, carafate, Prilosec, doxycycline, cerenia, and prednisone we started today.  Within 2 hours of carafate yesterday, he ate an entire can of the vet science diet ad.  He also ate a bit of his Fromm wet food and honest kitchen dehydrated. Had a BM that was very dark but not black and tarry looking.  So I do feel it could be an ulcer causing the anemia. This morning he’s exceptionally sleepy, his gums looked horrible first thing upon waking, but are now looking pale.   He has taken about half a can of the ad canned I offered but didn’t want anything else.  With levels this low, is there anything else I can try for my sweet boy to get him over “the hump” and towards healing? 

Thank you in advance.

Dr. Steve's Advice -  please check in with your vet to make sure that the pred and Galliprant are safe to use together. NSAIDs with steroids can actually increase the risk of ulcer. Please check to make sure that the drug combinations they have your dog on won't make things worse. You might be okay. The question needs to be asked though.

The other big rule out for your dog is some sort of hemolytic anemia, but with the GI symptoms predominating, it does seem like an ulcer is more likely, especially if he felt great after the sucralfate.

Generally my approach to stomach ulcers is a real food diet plus Glehnia and Rehmannia by Kan Essentials, often available online at Amazon in the US. Vets can source it as Yi Guan Jian from www.atimetohealherbs.com if they are interested in supporting you that way.

Minor Bupleurum versions such as Voltrex may be helpful as well to help deal with the arthritic pain and removing the propensity to ulcer. But I would try the Glehnia and Rehmannia approach first

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Hi Dr.Steve!

I was wondering if you would recommend Voltrex or anything else in addition to Lumbrex?

Biggest issue is back leg strength (he struggles to get up and then will pee) and vestibular disease. He's never quite recovered after his first episode. He circles sometimes and leans to his right side (even when sitting as shown in photo).

Lion's mane helped him walk straight and stopped the leaning for a few weeks before it came back when his UTI came back.

Quick recap:

-16 year old 50lb shepherd mix with severe arthritis.
-started Lumbrex on March 17. I'm almost certain this was what helped him with mobility. Even though he still needs assistance, he's able to get up on his own 75% of the time with a bit of struggling. 

-bloodwork is perfect except he has hypothyroidism and currently battling his 4th UTI in 3 months. He is on doxycycline hyclate. If this doesn't work, we will do x-rays for bladder stones. 

-weekly maintenance Adequan shots, daily infrared laser therapy + lumbrex + lion's mane + cranberry + green mussel + cosequin + probiotics + fish oil. 

THANK YOU SO MUCH 

Dr.'s Advice Steve -  you're working hard for your boy! One thing that is sort of a must-do if you have access to it is chiropractic. Fixations can aggravate weakness and incontinence. If the Lumbrex (https://goldstandardherbs.com/products...) helped, there are almost assuredly a few fixations there. Chiropractic may relieve the vertigo, too

In terms of what to add, given the frequent UTIs and the response to Lion's Mane, it seems your dog is immune deficient. Given that and the incontinence with increased abdominal pressure (as he is struggling to rise), I would try Lift the Qi by Kan Essentials, which you might be able to find on Amazon or order from Liz Appel by emailing her at lizappel22@gmail.com with DOG HERBS in the subject line.

Those would be the two things I would do next. Hopefully this helps you out!

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