It's always difficult to choose between fun for your dog and a possible - though not definite - health issue... For the record, I think you are definitely doing the right thing.
Charlie had his second injection of cartrophen last Thursday - the data sheet for Cartrophen show typical improvement after the second week. Up until Wednesday, he had been doing really well, only very minor stiffness that wore off very quickly - within 30 seconds of him getting up from rest. And perhaps I could see a bit of stiffness around his front when out and about but hardly anything. So, on Wednesday I decided we could return to training (as it had been 10 days) and did quite a light session with him around steadiness. He got his run around ball as a reward (so he ran around with it, obviously) and he did get to fetch the dummy a few times, but a very light session of less than an hour, with a lot of breaks and short strolls between bits of training. That evening, he was definitely stiff for a bit longer after rest, and that lasted until Thursday when he was stiff just for a little longer than normal as we set off to the vet's which is only a very short walk away, not even 10 minutes. By the time we got to the vet's though, he was walking completely normally, and the vet said Charlie wasn't showing any signs of stiffness at all, and on examination the vet said that Charlie wasn't showing any signs of sensitivity even though the vet extended his elbows further than he had last time when Charlie mouthed his hand. This just must be due to the rest, really, and not the Cartrophen because I wouldn't expect to see much improvement after only one injection. So, the vet says to carry on as we are, which is a lead walk of a hour, about 30mins off lead but staying quiet (no hoolies etc) and his other little outings on lead of 30 mins or so and we'll see how it goes - we go back next Wednesday for the 3rd injection. Even though the vet says Charlie seems better, I don't think I can say the Cartrophen has had any impact yet.
Lady had a course of Pentosan just about 6 months ago and is doing very well on it so far. She tended to slightly drop one shoulder and had reduced mass musculature in her shoulders. She had an intermittent left elbow acute pain as well. The dropped shoulder and elbow pain has gone completely but can't in all honesty see any difference in her shoulder muscles. I'm convinced the Pentosan works and I'll be giving her another course on the anniversary or earlier if needed.
Could it be that you don't see such an improvement over a short period as Charlie's symptoms weren't severe? I suspect, as you say, he may have been where he is today because of the rest. The next few weeks and months after the course is completed will show the improvement.
I'm a bit doubtful about the claims made for Cartrophen. In a clinical study, the effects of Cartrophen lasted 8 weeks, yet the manufacturer says based on 'vet experience' the effects last from about 3 to 12 months. But that sounds a bit dodgy, to be honest. I mean, perhaps a dog with joint trouble would have 1 to 4 limping/stiffness events a year and it's just the rest that helps. There doesn't seem to be a good reason why the effects of Cartrophen would last a year, really. Well, according to the one trial I can find, there isn't much difference in time to effectiveness based on the severity of the pain. The light blue is NSAIDs, the dark blue Cartrophen.
I always tend to doubt the claims of manufacturers particularly when clinical studies don't really support their claims. I would be interested to see the results on the effectiveness after the 7 week point to support their claims. I guess in some cases the effects could last for up to a year; just thinking of when I had a steroid injection in my right knee in 2011. My physo said the effects should lst between 3 and 6 months and I could have another injection after 6 months if necessary. I've neer had another injection and my knee has never been as painful since. That said though based upon the study graphs I don't think I'm convinced enough to consider Cartrophen any time soon for Juno, we'll stick with the very occasional NSAID and rest.
My vet is a little skeptical too. He said it was a treatment that was in and out of fashion and in his experience it worked in about 1/3 of dogs but the jury was still out on why it did work. Lady was getting quite severe pain intermittently in her left elbow when executing tight turns and she had a continuous very slight limp as evidenced by slightly dropping her shoulder when she walked. On the basis the course of 4 injections would at worst just waste a few pounds we decided between us to give it a go. Lady showed improvement towards the end of the course and I took her back for a review 4 weeks after the last injection. I can only report how she is. Her movement is easier, her shoulder dropping has gone, and she has had no problems with the really very severe intermittent pain in her left elbow when executing tight turns. She worked on a shoot as usual this season just gone and performed as normal including catching a few runners that required quick turns under pressure. She completed the course of injections mid-August. Whether it was the Pentosan or not - well who knows, but she's had no problems since and if I hadn't been really very concerned at the time I wouldn't have taken her to the vet or started the treatment. When I say severe pain in her elbow, she screamed out very loudly and fell in a heap whimpering and yelping - so really bad and it had me in tears. The vet thought it was probably a bit of bone-to-bone contact on turning (she's had both elbows operated on for ED). The Pentosan is supposed to last up to a year. So far we've done just about 7 months and although I'm cautious with her about what we do together she's living a pretty normal Labrador life. I'd love to see some unbiased clinical research results that addressed the snake oil suspicion, but all I can say is it seems to work with Lady.
Well, I'm happy to try it - my vet says he thinks some dogs do benefit, I've read the data sheets very carefully and side effects seem low. There are some, but since Charlie is sick on NSAIDs it's worth a try. I really want him to be able to train freely. I actually don't know how much to worry about the stiffness that wears off so quickly anyway. Right now, for the sake of avoiding that I'm stopping him doing something we both very much love and which keeps his hooligan tendencies under control so he has a great deal of freedom to be off lead. So, dunno. I'll discuss it with the vet again on Wednesday.
Well.....good news, so far, so good.... Charlie went to Cornwall - nightmare long journey stuck behind accidents in traffic jams, but my boy was as good as gold. Had to stop to make sure he was ok for water, gave him a walk to have a pee etc. He was bored but ok... He hasn't shown any signs of stiffness or limping since last week. He had time off lead over the weekend and today for 45mins - and he was a bit of a hooligan running round, as per...but no signs of stiffness at all. I am not putting this down to the Cartrophen, it very well may be as my vet speculated - he might have banged or twisted his elbow and a bit of rest has sorted it. Alternatively, he might be stiff again in a day or so....who knows? Anyway, it's all looking good, and we did a bit of training today, with no stiffness tonight. So, if it carries on like this, we'll train on Wednesday (after we've seen the vet) and Sunday.... Hoping it was just a twist or something temporary. Obviously, not getting my hopes up too much. You never know.....
Today Charlie had a vet check up, and the third Cartrophen injection. He got a clean bill of health from the vet, who thought Charlie had no sensitivity in his elbows at all. He also returned to a level of exercise that's about typical for a week day, 1 hr 40 mins off lead, and 1 hr 20 mins fast walking on lead (split across 4 walks). Well, not out of the woods yet because we have to see that he is not stiff tomorrow, but it's looking good..... Of course, we don't know that the Cartrophen worked, or a bit of rest did the trick, or it was a temporary twist/sprain that has now healed up. My vet thinks we can put the Cartrophen in the 'potentially works for Charlie' bucket. He'll do the final injection next week, then re-examine Charlie in 3 months to see if Charlie shows any signs of potentially benefiting from another course of 4 weeks or we should leave it longer.
So....still messing about with this. Sigh..... Last week, he seemed really fine. So on Wednesday I did some training with him - not a lot, mainly steadiness training, and I'd say the level of exercise was very, very light for an adult Labrador. He seemed fine. Then on Thursday, he got an extra off lead walk - I've been keeping his off lead walks very controlled. Calling him to heel if we meet other dogs, and putting him on lead around water so he doesn't start playing or doing water zoomies. But I relaxed a bit because I thought he seemed fine. But on Thursday night/Friday he was limping again. Not as bad as at the beginning, but definitely a limp rather than being stiff. About 2/10 lame, I'd say. So more rest over the weekend, and now he is fine again. He had 45 minutes off lead yesterday, staying quiet, and he is fine this morning. I just don't know what's going on, really. It seems likely to be arthritic to me and any excess of exercise makes him stiff/limp. On the up side, he seems to be able to do as much on lead walking as I like and he's fine. So at the moment he's getting an hour on lead in the morning, 30 - 45 mins trotting round off lead, and another couple of 30 minutes on lead in the afternoons. He seems fine with this but it's all a bit boring for him and I think he misses his training. I cancelled my 121 gundog lesson today again, because it would have been 2 hours training and far too big a jump from the level of exercise that I know he's ok with. Sigh.... Anyway, 4th Cartrophen injection today, and I'll talk it through with the vet, see what he thinks. In the meantime, since we are both going nuts not doing any training I'm trying to get a place on a scentwork workshop, I thought that seemed like something he'd be able to do ok. Give us something to work on while we see whether this dratted limp goes away....
