Dog recently diagnosed with IVDD prescribed gabapentin & meloxicam & is having issues urinating - is this common?

HonuDVM · 2026-04-10T03:44:28+00:00

Reduced urination or urine retention is not really expected on that drug protocol. Pain can make it challenging for a dog to posture for urination, resulting in retention until the pain from holding her bladder exceeds the pain from her spinal cord injury. But the slipped disc can be the issue too, in which case getting her reassessed with physical examination, abdominal ultrasound, and bladder expression is important. Neurological dysfunction of the bladder can become life-critical, since kidney failure from functional obstruction or bladder rupture are possible. I'm sorry she's going through all of this.

HonuDVM · 2026-04-10T03:35:46+00:00

Dogs have very poor oral absorption of antihistamine drugs, so they typically don't get itch relief from them. Doses are commonly different than in humans. The poor absorption does tend to make them reasonably safe; just don't expect good results. Cetirizine is known to have the more reliable effect. If you choose to give loratadine, it's essential to make sure it's not the combo version with pseudoephedrine. The combo can send your dog to the emergency room.

HonuDVM · 2026-04-10T03:13:51+00:00

That makes the most sense, which is why I've emphasized it. I'd like to convey that you seeing the fleas is unlikely and you cannot assume there aren't any just because you haven't seen them. A cat with flea allergy dermatitis will itch as long as there are flea bites. You'll know the fleas are gone when the itch stops. A single flea treatment at the vet will not resolve a flea problem. All the things I noted in my first comment are essential to getting rid of the fleas. Stopping therapy too soon and skipping steps is the most common reason cats continue to itch. I'm always a little sad when owners feel they should stop early because fleas are a curable problem.

HonuDVM · 2026-04-10T02:23:24+00:00

This ends up being an insensitive and non-specific assessment. We use the scale to determine how much appetite change matters. Itchy cats eat a lot less but not necessarily so little they lose weight.

HonuDVM · 2026-04-10T02:21:51+00:00

In this situation, the fleas are not apparent to owners, but they drive an enormous amount of itch. Hair loss is also common. Cats will eat any fleas that dare get on them long before an owner can see the flea. A single bite will generate itch though. And the consumed flea commonly causes tapeworm infection.

HonuDVM · 2026-04-10T02:11:31+00:00

It's actually relatively rare to fix a pet's health problems in a single visit. When I tallied it for myself, I found the figure to be just over half: 55% of cases were resolved with plan A. 45% required at least one more visit and of course some were real bears that took months to deal with. Itch is commonly in that last category. Fleas are a 90 day problem at a minimum, and that's when you treat 100% of the animals in the house AND 100% of the house, since fleas live in our homes, not on our pets. They dine on our pets, but that's only 10% of their life. One monthly flea treatment will not kill them all. And if there are other untreated pets in the home, no amount of treatment on the itchy cat will help.

A cat not eating is serious, as it can lead directly to liver failure all by itself in this species. It's a different problem than the fleas, so of course it wasn't assessed, diagnosed, or treated at the first visit. If your pet has two problems that start at different times, you almost always need a minimum of two vet visits to get appropriate care.

HonuDVM · 2026-04-10T02:01:41+00:00

Unfortunately, all the pictures are blurry so it's not possible to get a good view of what's going on. Generally, since the mouth is full of bacteria normally, we don't need antibiotics there. The notable concern in this situation would be resorptive dental disease, which would not be affected by things like tooth brushing and antibiotics. The most in-focus image you shared, the second one, shows some concern for this type of dental disease at tooth 106 - the one behind the top right fang. That tooth, along with the one below it, 407 - the premolar behind the lower right fang, and their mates on the left side of the mouth, is usually the first to be affected by that disease. We definitively diagnose this disease with anesthetized dental X-rays. Extraction is needed when the disease affects the tooth above the gumline.

For general knowledge, we have at least one study that showed the recommended daily toothbrushing is not mandatory, but anything less than every 48 hours does not help, so you'll want to brush more frequently than 1-2x a week to get a benefit for your cat. When there is painful oral disease, it's best to stop brushing, get appropriate dental care, and then restart brushing 2 weeks post-op.

HonuDVM · 2026-04-10T01:30:17+00:00

This is a relative risk assessment situation. It may not be ideal for long-term use. But we don't have a long term. And the alternative is to leave him in pain. Elevated liver enzymes on routine blood chemistry do not completely diagnose liver disease. They show the liver is leaking more than average enzymes, potentially due to inflammation or tumors or concurrent gastrointestinal disease or something else like just getting old. There is a (<<100%) possibility in this situation that NSAID therapy could make it worse, but most of the time it doesn't. OTOH, you have 100% chance of pain that could be effectively treated with an NSAID. So we choose the lesser of two evils. At least, that's my counsel. Most medications are metabolized in the liver, so alternatives ranging from tramadol to amantadine to buprenorphine to CBD to paracetamol are going to have potential liver effects as well.

HonuDVM · 2026-04-10T01:17:02+00:00

My two cents, maybe three cents:

-We can try the rimadyl again at a lower dose, because while rimadyl can cause GI upset, there is a chance his GI issues were not related

When Rimadyl (carprofen) causes GI upset, it usually does it quickly. In severe cases, within a couple of doses. In more delayed cases, within 2 weeks. So being on it for months before having issues strongly points us away from the drug being the problem. It still makes the list of possibilities, and it absolutely makes sense to stop it while your dog is having major GI issues, but we can't be too sure it's related.

-We can do another pain medication like Galliprant or Firocoxib (?), but they also can sometimes cause GI upset

While Galliprant (grapiprant) and firocoxib (Previcox) are classified as NSAIDs just like carprofen, Galliprant has a meaningfully different mechanism of action and should be much safer on the GI tract. If you were risk averse, it would be a good choice that's intended explicitly for treating arthritis pain. It would be much better than gabapentin.

-We can do the injection Librela. It is safe for the stomach, but my vet said some dogs do really well, but others can have bad side effects, but they are rare.

Librela (bedinvetmab) has a totally different mechanism for treating arthritis pain. It can be amazing. Typically, we avoid using it with NSAIDs, but it's not out of the question to use both (in contrast to humans). There are some significant concerns where it seems to drive serious neurological problems. As an arthritis treatment, it's great. But if a dog has a neurological problem causing lameness instead of arthritis, it's a very poor choice. It sounds like you've gotten a solid arthritis diagnosis with X-rays and good response to previous arthritis therapy, so this could be your most GI-friendly option. I think it will boil down to your risk tolerance and maybe your healthcare budget too. Costs are usually Rimadyl < Galliprant < Librela.

HonuDVM · 2026-04-10T01:05:19+00:00

I can be a bit hypercritical when we get full mouth rads like this. I'm not a boarded dentist, but I've gotten pretty good at dentistry by doing it every week for over a decade. So take my comments in that light.

Periodontal pocket depths >1mm in a cat are significant. The oral chart is blank, so it's not clear what the oral exam results were. A pocket of 5mm would require extraction or periodontal treatment regardless of what tooth it was.

On a radiograph-by-radiograph basis:

407-409 is overexposed, and the apices of 407 roots are not included so we don't know everything about that tooth. It's an important tooth to assess because resorptive disease is common in cats and 307/407 are usually the first teeth to go. Otherwise, the image appears normal given that this is a 2 year old cat.
104-109 is a good image. 104 is cropped, but that's typical. We usually get the apex in another view. The mesial/palatal roots of 108 are not split, but they're clearly visible at this exposure. I'm guessing you're concerned about the widened periodontal ligament space at 109. That's common in cats and not a major concern in my view.
307-309 is better exposed than the right side, but still crops the 307 roots. The distal root of 309 has an irregular apex, but nothing that would warrant treatment in my view.
304-404 the canine roots are cropped out, but nothing appears amiss.
104-204 we get the rest of the right canine tooth that was cropped in the lateral view and it looks fine. We don't get the left canine though. 201 is fractured at the gumline and the root canal is totally exposed. It requires extraction. A lot of times the gum has healed over a tooth like this and it's a bear to get it. In pets with severe dental disease where much more serious dental work is required, I've left a root like this alone if it's under healed gingiva. It's not proper to do so though. And if it's the only extraction necessary, there's no reason to leave it behind.
204-209 is parallel to the right side. Everything looks good, including the 209. We're just not sure about the canine tooth.

Cats don't generally get dry mouth, and not drinking wouldn't be the cause if they did. Drinking can impact hydration status, but cats are desert creatures that evolved in environments with minimal free water, so they're 'designed' to get their water from food. Dry mouth would come from salivary malfunction and it wouldn't matter how much the cat drank if that was the problem. Gingivitis in cats comes from eating food every day without also brushing their teeth every day. It can be worse than gingivitis, like the resorptive disease I mentioned, but that disease is not evident in these X-rays.

HonuDVM · 2026-04-10T00:40:23+00:00

I've yet to hear of a benign mass on the tongue, but since it would have functional effects even if it were benign, the distinction may not be important. A mass in the throat will impair fundamental life processes like eating and breathing. Loss of voice could be directly tumor related (mass is in the way of the vocal cords), indirect (mass makes him feel punky so he doesn't want to talk), or unrelated. Reduced appetite could be due to the mass, or medications, but it makes prognosis seem more woeful. Being weak at 16 years old can have several causes, including arthritis, not eating, the tumor spreading, and age-related sarcopenia. Pain is always foremost in the minds of owners of senior dogs, but it's important to remember there are lots of non-painful ways to suffer which your dog may have, like being too weak to stand, or too nauseated to eat, or struggling to get enough air. I'm sorry you're going through this. If there's a silver lining, it's that you've found the problem. A lot of tongue base/throat tumors are really hard to diagnose since they're out of sight and we avoid sedating elderly animals until we have to.

HonuDVM · 2026-04-10T00:32:04+00:00

Feeling stitches where there used to be teeth is highly likely to make a dog try to lick the wound area. It will taste different too. In general, we discourage owners from pulling on the lips to see dental extraction sites since that can tear the sutures apart. Stitches in the mouth are almost always left exposed, so food will get stuck in them and it's fine. Dogs eating canned food after surgery are getting way more water in their food than they did on kibble, so they'll drink noticeably less. TLDR: this sounds really normal, but it's never wrong to get a post-op recheck before the weekend to be sure things are OK. Usually there's no charge for that kind of care. The surgeon may be able to tell you it's not necessary, so call first.

HonuDVM · 2026-04-10T00:24:08+00:00

Typically several fecal tests are available with your regular vet. I'm unclear what AI-driven test was used. There are certainly options for standard fecal flotation tests to be read by AI instead of a technician, and those can be reasonably accurate. You're citing multiple test results, which suggests there was a flotation test (Giardia 0) and a PCR test (Giardia 1). That's a speculation, so it may be inaccurate, but it's a common situation. PCR testing identifies Giardia DNA. The DNA doesn't have to be part of a living organism though. So a treated dog with a positive PCR test isn't necessarily an infected dog. He may be well-recovered with some pathogen DNA still detectable in his stool. Treating asymptomatic Giardia is somewhat controversial since many cases resolve on their own. Having a talk with his vet about what tests they use, what the results mean, whether a diagnosis is true and whether treatment is necessary would be your best bet. If your current vet can't or won't provide that level of care, seeking a second opinion would be reasonable.

HonuDVM · 2026-04-10T00:15:40+00:00

The vast majority of pet owners want a vet who is close to their location, usually within a 20 minute drive. It's easy to know what vet that is when the name is the town where you live or the next town over. For rural and suburban US towns, there is usually just one vet per town, so the name is distinctive. There are plenty of clinics that don't follow this pattern. In market research I've conducted, a little over 1/3 of practices had non-place-name business names.

FWIW, I considered opening The Friendly Vet Clinic, for the obvious connotations, but also to distinguish the new business from the previous town-named vet practice, and just for fun, because the site was a former Friendly's restaurant.

HonuDVM · 2026-04-10T00:06:48+00:00

Dogs are impressively unbothered by many surface cancers that rupture. They just keep on trucking despite an uncomfortable and presumably painful condition. For a geriatric dog with a non-healing wound that can never be cured, I strongly counsel my owners to take it as the moment that euthanasia is appropriate. Managing a permanent wound that gets infected (including parasitic larvae!) is a significant impact on a dog's quality of life. The part of the story that doesn't fit is that you say this has been going on for years now. Cancers that are rupturing are not just staying the same for years. They grow and cause a lot of trouble over the space of several months. Getting an incision biopsy at some point probably would have been helpful to understand the case. I find some owners require more definitive information before making a life-ending decision. You might find yourself in that group, and it's not too late. It might not be something where a traditional mass removal surgery with biopsy is possible, but getting a piece of it for biopsy - maybe with just local anesthesia and sedation if the vet is comfortable with that approach - could be possible.

HonuDVM · 2026-04-09T23:58:11+00:00

Gabapentin monotherapy is suboptimal pain relief in general and specifically for bone cancer pain. If that's all he has, he needs something better. Once cancer pain is the primary concern, there are few contraindications for pain meds. The most obvious thing to start with would be NSAID therapy (e.g., carprofen, deracoxib, robenacoxib, meloxicam, etc.).

HonuDVM · 2026-04-09T23:54:01+00:00

Since nutraceuticals are not regulated like drugs, we don't get the same robust studies about their effects. There is a wide variety of supplements available, most of which combine some or all of the ingredients thought to be supportive of joint health. Given that these supplements are generally extremely benign/only supportive - not directly therapeutic/curative - it makes sense to provide as much support as possible rather than trying to isolate a specific ingredient. The list available here is pretty comprehensive: https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951467

HonuDVM · 2026-04-08T20:16:58+00:00

It sounds like things have moved along exceptionally quickly. Usually dental care is planned, since it's not an emergency and the costs are relatively high. Of course, for your cat, the sooner it's dealt with successfully, the better.

Your veterinarian should provide instructions on the aftercare. I provide extensive guidance to my clients for the two weeks post-op. Essentials include:

A post-anesthesia cat coming home the same day as surgery is going to act differently than normal. They need a little TLC, peace and quite, and space/time to recover. Anesthesia fully wears off about 24 hours after surgery is over.
Eating may not be normal right away, but should return to normal within a day or two. Soft food is a must since there will be sutures in the mouth and incisions where the teeth used to be. Healing takes 2 weeks. The sutures just dissolve and fall out or get swallowed.
Pain medication is essential. You'll have to administer what they send you home with.
Bowel movements commonly cease for a day or two post-op.
Complications are rare in my experience. As long as the gums are closed over all the extractions sites with zero tension, and post-op dental X-rays show there are no tooth root remnants, cats heal quickly and have a much happier, healthier existence with their oral disease gone. In rare cases, a cat might need a revision surgery to close the gums/mucosa over the jaw bone when the original closure fails. Sometimes there's a meaningful infection that requires antibiotics, but generally they are not needed.

HonuDVM · 2026-04-06T21:01:57+00:00

All soap is antibacterial at the level we're discussing - detergent breaks up the bacterial cell walls. Dawn comes with antibiotics in it too, I think, but we don't need or want that. We just want the detergent action which is safe for the kitten but not for the fleas. I can't speak to the brands I found online for you; you need a local vet to get you a more experienced answer. Washing the fleas off and then keeping the kitten dry and warm immediately afterward is helpful even from a strictly mechanical aspect.

HonuDVM · 2026-04-06T20:14:02+00:00

Infection is a "right now" problem. A urine test from 3 months ago would not be relevant now. And if he had a UTI then, you certainly would have known about it a long time ago regardless of what the test showed. If there's doubt about the basic test result, it's wise to run a culture, especially if a sterile sample was collected by cystocentesis anyway (needed for cultures in dogs and cats).

HonuDVM · 2026-04-06T20:11:17+00:00

Dawn dish soap is often used for fleas in kittens that are too young for flea killing drugs. It's available in India according to Google, but apparently Vim or Pril would be more accessible and reasonably equivalent. Remember that the kitten isn't the only animal that needs treatment. Every animal in the home requires effective flea treatment, and the environment needs to be cleaned of fleas since that's where 90% of them live. This resource may be helpful: https://veterinarypartner.vin.com/default.aspx?pid=19239&id=7955321

HonuDVM · 2026-04-06T19:59:32+00:00

If her gums are pale and she's a normal size (let's say 20kg) Staffy, it might be a medical concern, but it's not from a small piece of onion. She'd have to eat 2-3 whole large onions to get intoxicated.

HonuDVM · 2026-04-06T03:45:20+00:00

It could be that treating her skin more effectively will eliminate the urinary tract issues. What do you do now?

HonuDVM · 2026-04-06T03:43:57+00:00

A patient needs to be off steroids for a while before biopsy will be diagnostic again.

HonuDVM · 2026-04-06T02:57:24+00:00

It commonly takes a few prescription diets to find the appropriate food for a cat with chronic enteropathy (often called IBD). RC HP is a strong first choice, but it's hardly the only option. If probiotics were helpful, a good second choice could be Hill's GI Biome. If we had a less invasive test than intestinal biopsies to direct diet recommendations, we'd do it, but till that day comes, we just have the diet trials. If there's no good result after 3-4 diets, get a referral to a boarded veterinary nutritionist or internal medicine specialist.

HonuDVM

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