How would you schedule these meds? (Dog)

[Drama Llama]

My 16 year old dog has been getting Librela shots for about 6 months and is better than he was before he started, but we are seeing more difficulties.  He tires easily, it takes him a long time to get up.  His tail is always down, which the vet says is probably not sadness but arthritis in his spine. 

Any way he still is always happy to see us or to go for a short walk, and he gets super excited at meal times, so we are hoping to improve his quality of life for as long as possible.

My vet gave me 30 doses of carprofen and 30 doses of gabapentin and told us to try both and see how it goes.  

How would you do this?  A few days of one then a few days of the other then a few days of both?  Or something else?  I don't know how they work, so I don't know how many days I'd need to see.

[Pawz4me]

I think I'd try a few days of carprofen and then add in the gabapentin if I felt more was needed. It has a fairly strong sedative effect (that's actually how I'm most familiar with using it).

Or depending on the dosing instructions given I might give carprofen in the morning and both in the evening. Since the gabapentin has a sedative effect it could help with sleep. If he's alone during the day . . you might want to see how loopy he gets on gabapentin before leaving him alone while taking it.

IME they both work pretty fast. Carprofen is an NSAID, so it's similar to us taking ibuprofen. I've mostly used gabapentin for calming after surgeries or for noise phobias, and it seems to take 30-45 minutes to kick in for that. I'd think the effect on neuropathic pain would be about the same time frame, but that's a guess.

[WildflowerMom]

Well, from what I understand (someone correct me if I’m wrong), carprofen is like ibuprofen and gaba is a nerve med, so I would give them together.    

[WildflowerMom]

Yes, I agree with trying both at night at bedtime the first few times.  

[Bambam]

A relative gives her dog gabapentin for anxiety. Originally two pills, but now he is just on one given in the morning.  

[Drama Llama]

I don't want to just give both, because I feel like both have downsides (liver/kidney issues with carprofen, sedation with gabapentin, cost for both) so I want to see if both is better than just one or just the other.  So, I definitely want to try each one alone, as well as together.  

[itsheresomewhere]

I do both- one in the morning and the other one at night.  It seems to work for my elderly dachshund well along with the liberla.  I will increase the meds when she needs more without hesitation. 
 

The vet I work for would tell you to try the lowest dose of both first and see how it goes.  At that age, many things could happen from age and not just the kidneys from meds.  You want the pup to enjoy the life they have left in as little pain as possible ( remember we don’t always see the pain they are in until it is bad as some will hide it).  

[Drama Llama]

To be clear, if it takes both to make him feel better, then of course we'll give him both.  But I don't want to start with both, I want to find out what the results are from each one to make sure that both is what makes sense. 

I think we'll try the gabapentin first, because we're home a lot tomorrow, so we can watch for the sedation.  

I am not actually sure how I will know if he's in or out of pain.  I had been assuming that he'd go back to the level of tail wagging he had before, but the vet said that it's likely he has some arthritis in his spine, and that those muscles have weakened with age, and that not wagging his tail isn't a sign that he is unhappy.  I know that not eating, or not wanting to go on walks, or not getting up to greet us when he figures out we're home (he's really deaf so he no longer goes to the door when he hears footsteps), or not following us up stairs at bedtime would be bad signs but we don't see any of those things. What we do see is that it takes him longer to get to his feet.  He doesn't follow everyone upstairs every time, just the last person up at night.  His stance is a little wider, and his gait a lot slower.  He enjoys shorter walks, and we no longer take him down the steep outside stairs to the backyard and instead walking him around the outside of the house to the gate.  And when the librela is wearing off near the end of the 4 weeks, he sometimes sits to eat, which the vet says is unusual because usually standing is easier than getting into a sitting position.  He also doesn't jump up onto regular height beds or the couch or a vehicle, but will use the trundle in my kids room to climb into the bottom bunk with his boy, and will let you lift him onto the couch or into the car.  

[Bambam]

If cost is an issue, my sister gets her dogs prescriptions filled at Costco. She says it is less expensive than the vet. She gets gabapentin there as well as some cardiac med for her dogs.  I looked at the bottle - Dog's name + her last name. 

[Drama Llama]

34 minutes ago, Bambam said:

If cost is an issue, my sister gets her dogs prescriptions filled at Costco. She says it is less expensive than the vet. She gets gabapentin there as well as some cardiac med for her dogs.  I looked at the bottle - Dog's name + her last name. 

We'll look for the cheapest place to fill them because I'm frugal, but it's not a huge burden.  If he needs them, we can get them for him.  

If my vet had said "I think he should take these two meds", I would give him the meds.  The vet didn't say that.  The vet said "I think he looks a lot better than pre-librela, do you have concerns?" and I said I agreed but wondered if it could be even better, and he said "let me send you home with a small amount of both, and you can try them and then let me know if you want to add one or the other or both."  

[Drama Llama]

OK, so I think my deaf dog can lipread, because all the things I told my vet he doesn't do he's like "look at me I am jumping!" and "Here I will put my paws on your leg" and "Oh, boy, are you going upstairs?  I will come!"  today.  I assume it's the fresh librela, and will wear off.  Maybe he just needs meds the last two weeks?

I'm going to give him gabapentin tomorrow to see the sedation since we will be around more than usual, and then just wait till he has symptoms.  

[Rosla]

Since the vet prescribed two meds, I would give them together. But maybe I'd try giving one in the morning and another in the evening like it was mentioned above. I can also suggest checking a Pet Prescription Without Vet blog. I look through it now and then and often find some useful info there. Maybe you will also find it helpful.

Edited May 30 by Rosla