Learned a new word(s) today. For my birthday (shut up! don't rush me), my MIL gave me 50€ and Nick offered to give me 30€ toward the Obama campaign if I wanted the T-shirt. I took the 30€, added some debt, and got what I really wanted: a visit to Io Jima's orthopedic surgeon so I can find out what's actually wrong with Nala and what, if anything, to do about it. She fell going up the stairs the other night and had one helluva time getting going, again.
He did X-rays. The first ones. (It took 3 people to hold her; like most Chows, she hates being laid down.) So, right: she's got arthritis. Not in her left shoulder as we thought, but in both elbows, the right one being the worst. How odd! It's the left leg that appears to constantly collapse on her. Anyway, worst is the operative word. Dr. Garcin said he'd never seen such awful arthritis. Ever. Looking at a line on the X-rays, he believes that she suffered a trauma when young that gave rise to Ununited Aconeal Process, which gives a worst case prognosis for arthritis.
Nothing much to do. He approved of the Cosiflex. I asked after joint replacements. Hips only, he said; there is no procedure, yet, for elbows.
We discussed NSAIDs. I said she'd tried them all; made her sick. But we've agreed to try the Metacam, again. She did better on it; took a week for her to get diarrhea. But I'm giving her a half dose and he's prescribed Cytotec to protect her stomach.
Let's see. 30€ for the Metacam. 20€ for the Cytotec. 28.50€ for her eyedrops. 10€ for the other eyedrops. 23.50€ for the Advantix because it has to be given every 2 weeks for the Leishmaniosis. 12.50€ for the sebhorrhea shampoo, the only thing that lasts longer than a month, so lets say 5.00€. You add it up.
So, I said to the pharmacist -- after I found out the price of the Cytotec -- Nala tolerated the aspirin pretty well, too. Could I give her the Cytotec with aspirin instead of Metacam. No, he said, it doesn't work with aspirin. But it does, according to the site cited above.
Pretty soon I will buy her a harness to help her get up the stairs.
Meanwhile, I wish Dr.Garcin were our regular vet. He immediately identified Nala's on-going eye problem (now that the entropion has been surgically corrected), as ectropion of the right eye; hence all the infections. (To the above list, add the antibiotic ointments for her constant eye infections). He took one look at the X-rays and knew what the problem was. He grimaced when I said she hadn't been X-rayed before. And, in general, he seems to know everything.
The only good news. The visit, meds, X-rays and all came to 137€. If it weren't for running costs, we'd be in clover.
End of whinge.