Common Eye Problems in Dogs and How to Treat Them

There Are Many Effective Therapies For Dogs With Osteoarthritis [Ask The Vet]

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Vet-Approved Home Treatment For Senior Dogs With Arthritis

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"Can you please give us your differential plus suggested action? Our 13-year-old Tibetan Terrier is in great health but was suddenly tired when we were headed to the vet to check the limping on her front left leg. The day before the vet appointment, we saw extreme fatigue, her hind legs weakened then dragged, and then she could walk slowly but was crossing her right rear foot behind the left rear foot, with her pads up.

If this is myelopathy, will she recover? Is there something to do without expensive tests? Is euthanasia what owners consider doing at this point? We are just heartbroken, and I feel awful, like I missed some obvious signals. Thank you so much for your help."

Related: Why Can't My Dog Stand on His Back Legs?

Possible Causes of Dragging and Limping in Senior Dogs

A: There are many possible causes of limping in the back legs and dragging the back legs in a dog this age:

Arthritis: When senior dogs develop changes in their vertebral bones, their spine can be pressed upon, and they can display the type of changes in the back legs that you describe.

Cancer: A tumor that presses on the spinal cord can cause a dog to become lame and walk on the top of the paws.

Embolism: A blood clot that causes death of the cells in the spinal column could cause limping like this.

Intervertebral disc disease (IVDD): This is a disease of the bones in the back where the discs harden and push down on the spinal column. Dogs with IVDD drag their rear feet and sometimes knuckle over similar to what you described.

Myelopathy: Tibetan Terriers are one of the dog breeds that can inherit this disease. This problem can only be diagnosed if all the other problems that cause similar symptoms are ruled out (1), so just limping and walking on the top of the feet could be caused by something else on this list.

Tick-borne disease: Lyme disease can cause lameness in dogs about 5 or 6 months after being exposed. The lameness can move between different legs, similar to what you described as starting in the front and later affecting the rear legs.

Hip dysplasia: This condition is a problem in Tibetan Terriers but does not usually cause the symptoms you describe (2). If it started out as bunny-hopping when she was running and a reluctance to get up when down or climb up stairs, this would be more likely. Some senior dogs, however, will develop arthritis in the hip joints and can have symptoms like you describe.

The Least Expensive Plan

The best thing you could do for her at this point is to have her examined so that you can look for signs of disc disease, cancer in the back, or bony changes of arthritis. An exam would not cost much, but she will probably also need x-rays and blood tests, and in some cases, dogs need a CT exam or a spinal tap.

If you can afford surgery, a disease like IVDD can be cured. If you cannot afford the diagnostics at this time, my suggestion would be to treat this like a case of arthritis with some impingement on the nerves.

Related: Dog Arthritis Symptoms and Home Pain Remedies

Things You Can Do at Home for a Dog With Arthritis

Nothing you do for arthritis is going to make your dog any worse if she has myelopathy or cancer. There is no cure for arthritis, but there is a lot you can do to keep your dog comfortable at home for a long time to come:

Diet

There is no cure for arthritis, but making up a diet that provides adequate omega-3 fatty acids and antioxidants can increase her quality of life and may increase her lifespan. I have included here a recipe to make up food for dogs with arthritis and encourage you to change your dog's diet as soon as possible.

Pain Medications

You will need to get prescription pain medications from your veterinarian, but there are some options if you cannot go that route. Since not all dogs do well with the normal pain meds (like aspirin, meloxicam, etc.), you can try CBD oil. You will have to get it from the internet and follow the dosing schedule suggested by the manufacturer.

Appropriate Exercise

The best exercise for a dog like this is low-impact, like swimming. If you do not have access to a pool or beach, it is best to take her for short walks several times a day instead of one long walk, which could be hard on her.

Changes in Your House

No matter what the cause of the spinal disease, making changes around the house can help a lot. Ramps help dogs get up the stairs and get onto the bed or couch, and with training, a dog will learn to use a ramp instead of jumping down.

Glucosamine

There is still not adequate evidence that this supplement is effective, but in its natural form (like chicken feet) it can be added to the diet and may help the joints. There are several brands of capsules that might help, but if you get the human formulation from a drug store, there is a risk of poisoning if it is sweetened with xylitol.

Related: Foods High in Glucosamine for Dogs: Chicken Feet, Beef Tracheas, and More

Acupressure

This therapy works by returning the balance to a dog's yin and yang, according to the Chinese, or by pressing the muscles and improving circulation, similar to massage. This will not cure arthritis, but it can help your dog feel better. Learn more about how to perform the acupressure technique here.

When Is It Going to Be Time to Put Her to Sleep?

If this is myelopathy, your dog will not recover. I would have been more likely to agree that this was a case of myelopathy if you had not mentioned the limping in the front leg. It is possible that it was unrelated, of course, but this could be arthritis that will respond to therapy at home.

If this is myelopathy, your dog will continue to get worse and display other symptoms, like an inability to control the bladder. Some families do choose euthanasia early depending on the weight of the dog and the condition of the people in the house. If your dog is 30 pounds and no one in the household is able to lift a dog that size, she will probably need to be put down before she gets severe.

It is anywhere from 6 months to over a year from the time when she starts limping and dragging her toes until most people choose to put their dogs to sleep. This is often because the dogs are no longer able to urinate and have to be catheterized every day.

Up Next:

Related: Five Ways to Give Comfort to Your Senior Dog

Sources

Bouché TV, Coates JR, Moore SA, Faissler D, Rishniw M, Olby NJ. Diagnosis and management of dogs with degenerative myelopathy: A survey of neurologists and rehabilitation professionals. J Vet Intern Med. 2023 Sep-Oct;37(5):1815-1820. Doi: 10.1111/jvim.16829. Epub 2023 Aug 22. PMID: 37606360; PMCID: PMC10472985. Https://pmc.Ncbi.Nlm.Nih.Gov/articles/PMC10472985/

Popular Arthritis Drug For Dogs May Have Severe Side Effects, FDA Says

A popular drug for dogs with arthritis may be associated with a variety of potentially severe neurological effects, including seizures and a loss of muscle control, according to a recent review by the U.S. Food and Drug Administration, which approved the drug in 2023. In some cases, dogs have died or have been euthanized after developing these symptoms, the agency noted.

The drug, called Librela, is an injection of monoclonal antibodies that is approved for arthritis-related pain in dogs. Its label lists mostly mild side effects, such as urinary tract and skin infections.

But since the drug became widely available, some pet owners have reported that their dogs became seriously ill, lost the ability to walk or stand or even died shortly after receiving the drug.

The FDA's analysis, which is based on more than 3,600 adverse-event reports submitted to the agency and the drug manufacturer, does not prove that Librela caused these problems or estimate how frequently they might occur.

But such reviews can help regulators identify potential side effects that smaller clinical trials may have missed. The FDA has alerted veterinarians to the adverse events that may be associated with Librela and recommended that the drug's label be updated to include them.

Zoetis, the company that makes Librela, said that more than 21 million doses of the drug had been distributed globally and that side effects were rare. "We at Zoetis — and I personally — stand 100% behind Librela as safe and effective," said Dr. Richard Goldstein, the company's chief medical officer.

It is not uncommon for a drug's label to be revised after approval, and Zoetis is "working actively" with the agency on that process, Goldstein said.

Librela contains monoclonal antibodies that block the activity of nerve growth factor, a protein that plays a key role in the transmission of pain signals inside the body. In some dogs, it can have enormous benefits, veterinarians say, significantly improving their mobility and quality of life.

"This is a drug that has a place, and I think an important place," said Dr. Rory Todhunter, a veterinarian who directs the Richard P. Riney Canine Health Center at Cornell University. "I just think owners need to be warned that there are risks involved."

The FDA's review and its recommendation for updated labeling came as vindication to pet owners who say that their dogs have been seriously harmed by Librela and who have been trying to draw attention to the issue.

"To tell you that we're thrilled is just an understatement," said Lita Dwight, a co-executive director of Paws Over Profits, a nonprofit group that aims to raise awareness about the drug's potential side effects.

Dwight co-founded the organization after her miniature dachshund Lacey became seriously ill and then died shortly after receiving her first dose of Librela. She had not been warned about the possibility of severe side effects, she said.

"As a pet parent, I want informed consent," Dwight said. "I want the doctor to know what the side effects are, to give me the choice of whether or not I want to take on that risk."

The drug, which was authorized in Europe in 2020, was approved in the United States in May 2023. Reports of serious side effects soon began to spread online, in places including large Facebook groups, where some dog owners shared success stories and others relayed tragic ones.

Because Librela is generally given to older dogs, which may have a variety of underlying health issues, it has been difficult to determine whether the drug itself has been the cause of the severe symptoms reported in some dogs.

"A lot of old dogs have arthritis plus neurologic disease, and sometimes it's hard to tell a difference between the two," Todhunter said.

Still, the FDA identified a number of side effects that were reported more often in dogs given Librela than in those taking other drugs for arthritis pain. Those included a loss of muscle coordination and control, which was the most common adverse event reported, as well as muscle weakness, lameness, paralysis and an inability to stand.

The FDA review dismissed the possibility that discussions of Librela on social media had caused an overreporting of adverse events. "There is no evidence that the cases being reported are not true cases associated with Librela," the agency noted.

More research is required to identify the exact causes of and risk factors for potential side effects, said Todhunter, who noted that the drug might not be a good choice for dogs that have underlying neurological conditions.

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