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A month ago I learned my 5 year old Shih Tzu has osteoarthritis in her right hip. After giving her Rimadyl for one week, she seemed her normal spunky self. I decided to give her glucosamine supplements and up until 2 weeks ago, she seemed okay. Within the last 2 weeks, she has refused to eat anything, including her favorite treats. I took her to the vet and he felt the supplement was too strong for her and may have been upsetting her belly even though she'd been off of it for nearly a week. She was put on Clavomaxx and Metronidazole. After a couple of days and a visit from her brother, she seemed to be okay. A day later after going out to potty, she collapsed! It happened so quickly, I can't say for sure whether or not she was unconscious, but if she was, it lasted a few seconds. I immediately put her in the car & we headed for the ER. On the way there, she was delighted to be going for a ride. Once there, the vet found she had pain in her lower back and treated her for a herniated disc & referred us back to our regular vet for the next bus. day. She was given 3 shots at the ER and I know one was a muscle relaxer. By the time we got home, she seemed okay and ate some of her food. When we visited her vet, she showed no signs of pain and he wasn't convinced it was her back and thought it may be heer hip. She was placed on previcox and tramadol and home we went. She seemed happy and ate when we got home, but as the evening went on, she seemed withdrawn and sad as if she's not feeling well. She has remained that way and has stopped eating. She has pooped once and it was massive and very soft. Her temp, blood work, & heart related tests came back normal.
What in the world could this be?

Customer (name blocked for privacy)

Status: Closed Value: $10

Could you list what drugs the dog has been on the last 2 weeks and and what she is taking now, including dosages. Also, when did she go to the ER and do you know what she was given there. I am getting lost in all the polypharmacy.

Holistic Wellness Care

Reply to Andrea J Cecur DVM's Post: Hi,
Here is the run down on recent medication for Miss Diamond...

June 24 - July 12 Glucosamine 1000mg/day as instructed by Vet. At the time, he didn't realized I bought it at Target and I didn't know it mattered.

July 12- July 19 very little appetite & no medication

July 20 - took her to the vet where she was prescribed Clavamox 125mg - 1 tab twice/day &
Metronidazole 250 mg - 1/2 tab twice/day

July 22 - I noticed she was limping and since she has arthritis, I gave her a Rimadyl 25mg and thought this may be the reason for her not eating. I stopped giving her the clavamox & metronidazole

July 23 - 2 doses of Rimadyl

July 24 - date of collapse and trip to the ER. I didn't administer any medication. She was given 3 medications (I don't remember the names but I know one was a muscle relaxer and I think it begins with a "D") through a butterfly catheter.

July 25 - To regular vet and prescribed Previcox 57mg - 1/2 tab/day & Tramadol 50 mg 1/2 tab twice/day.

July 26 - began giving her the new medications and nothing more.

I hope this makes some sort of sense.
Thank you

I don't think I could have kept that in order!;-)
Lets take it from the top!
1.The glucosamine dose was about double what I would give for a loading dose for a small dog. Maintenance dose would be about 250mg daily for a 10-20lb dog. This is most likely what caused her initial GI upset. Human products of plain glucosamine HCl can be given safely if at the correct dose.
2.What was the rationale for giving the Clavamox and Metronidazole? Did she have a fever indicating infection brewing somewhere?
3.Some dogs can have an intolerance to Rimadyl, but I would think she would have shown this the first time she took it. Documented reactions include: inappetance, GI bleeding, ataxia, disorientation, lethargy among many others.
4. My guess is one of the injections at the ER was a muscle relaxant (Dantrolene maybe?), a steroid and the third I don't know.
5. The Tramadol (indicated for pain) may induce sedation and cause upset stomach. This could be part of the reason she is depressed and not eating well. Her dosage may need to be adjusted. If she is really not painful she may not need the Tramadol at all, the Previcox (NSAID like Rimadyl- but said to have less side effects) may be enough. You don't know which is effective if given all together.
I'm not there to get all the subtle facts of the case, but it seems to me she's been getting too many drugs all at once. I would talk to your vet and tell him what has happened since starting these new drugs and question if it may be too much for her at once. Maybe just stick to the Previcox only to see if it alone is sufficient - the less drugs the better.

Edited by harmonyvet on July 27 2005 at 7:18 PM

Holistic Wellness Care

I've been afraid that these are too many medications for her. She is about 16 pounds. How long should it take for so much Glucosamine to leave her system? I would think it would be gone by now.
To my knowledge, she hasn't had a fever and each time I've dropped her off at the vet on my way to work, she's been wonderful according to them. Go figure!
I've been able to keep the dates straight by a journal I began to keep when I learned of the side effects of Rimadyl and by the number of checks I've written with our many trips to the vet. I'll try the Previcox alone and see how that works. Thanks!

I hope you can get things straightened out! Thank goodness for your journal. Not that I want to further complicate things, but the administration of a probiotic for a week or so to help her GI tract flora re-establish normalcy and help get her stool back to normal after all the meds might help. A couple that are pretty good are Fastrack and Probios.

Holistic Wellness Care

Reply to Andrea J Cecur DVM's Post: Are those prescription only medications? I don't think my vet will have a problem giving them to me, but if he does, how long do you think it will take her to get back to normal without them? The issue now is getting her to eat her food again so she'll be able to pass solid waste. She has shown some interest in her treats so I figure that's a good sign.
Thanks,
Tameka & Diamond

They are not prescription meds, they are just a dietary supplement with the good bacteria that are present in the healthy GI tract. Your vet might keep them on hand or some pet stores may carry them. They would just be an extra support, not absolutely necessary. If she is showing interest in food, that's a great sign. Offer her her favorite regular food and make sure she's drinking. If it was just the Tramadol making her dopey, she should be feeling a lot better by tomorrow.

Holistic Wellness Care

Reply to Andrea J Cecur DVM's Post: Hi,
I only gave her the Previcox today and she seemed a little more like herself when I got home from work today. She even went for a walk! Although we didn't walk as far as we normally do, she still had energy to do so and seemed excited about it. She pooped and although it was soft, there was form to it. She is not yet showing interest in her normal food and seems interested only in her pupperoni treats which she gets when I leave for work.
Tonight I'm going to try putting some plain broth on her food to see if that'll entice her.
I've not had any problems with her drinking water.
Thanks,
Tameka

Great! The broth should get her interested. You can even boil up a little chicken meat and rice. Once she gets back to her old eating routine, her poop should straighten up.

Holistic Wellness Care

Reply to Andrea J Cecur DVM's Post: Thank you very much for your help. I added chicken to the broth and she ate that out of her food and ate a couple of pieces but was more interested in the meat. That's a good sign and not unlike her.

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