Injured iliopsoas can be a bear to treat.
During the orthopedic specialist’s exam, it turned out there was more pain going on than Cookie was letting on. We already had the experience with this injury from the past. With Jasmine, it took a very long time for her iliopsoas to heal.
Besides strict rest, it was important to manage pain and inflammation as well.
Addressing inflammation
Inflammation is a tricky thing. It is an important part of the healing process unless it gets out of hand or becomes chronic. You want just the right amount for a specific period of time so damaged tissues can heal. But you don’t want it getting out of hand. That’s why, when we were discussing pain management for Cookie, I agreed to short-term NSAIDs.
NSAIDs
We agreed to short-term NSAIDs to relieve pain and calm down the inflammation.
Because Cookie had her blood work done shortly before all this happened, I knew her organs were functioning properly. And as much as I am not a fan of this medication, this was the time and place to use it.
Other pain medications
We also discussed other pain relievers such as Gabapentin and Tramadol.
Such things are often used together because they attack pain in different ways. While NSAIDs reduce pain by reducing inflammation, drugs such as Gabapentin or Tramadol bring pain relief by altering the brain’s perception of it.
I consider these two reasonably safe. Jasmine was on them.
Tramadol is meant to bring immediate relief and with Jasmine, it was used on as needed bases. Gabapentin works long-term.
While I didn’t rule out the possibility of using these, we decided not to start them at that point.
For one thing, Gabapentin takes quite a while before it takes effect. And while we did have Jasmine on these, and many dogs do find relief on them, we haven’t seen them doing anything for Jasmine at any point she was on them. That doesn’t mean it wouldn’t have worked for Cookie, it works for many dogs. However, we decided to keep them as a plan B.
For our plan A, I wanted to focus on a more integrative approach.
You can read more about how various pain medications work here.
Non-drug options
Armed with the results of the orthopedic specialist’s consultation, I discussed our options with Cookie’s primary vet. I wanted to have laser therapy and/or acupuncture, together with TCVM herbs as our primary weapons.
We also discussed the fact that it one of the few papers on iliopsoas muscle injuries out there, long-term NSAIDs actually interfere with the healing process.
After a short-course, we replaced the NSAIDs with a muscle relaxant and TCVM herbs, while we started physical therapy and laser therapy for Cookie.
Muscle relaxant
The muscle relaxant does what you’d figure, relaxes the muscles.
That helps in two ways. Injured muscles like to go into spasms which, of course, causes pain. And muscle tissue can only heal in a relaxed state. In people, muscle relaxants have been associated with better recovery.
So, besides Trazodone, that’s what Cookie is on now.
TCVM herbs
From the TCVM herbs, we considered two formulas, Body Sore which Jasmine used to get as well, and our new vet’s favorite, DOK’s Formula.
We got both but Cookie is getting the DOK’s Formula and it seems to be working well for her.
Other than she hates the smell/taste. At first, we got a jar with powder because that was the only one in stock and we didn’t want to wait for a new order to come in. Jasmine had no issues having her herbs mixed directly into her food, in fact, I think she liked having her food “seasoned.”
Cookie, however, figured her food was “contaminated” and didn’t want to have anything to do with it. She was okay having it mixed with peanut butter but with the amount, she was supposed to be getting she’d have to eat enormous amounts of peanut butter. Which would be fine except she’s already putting on some weight because of the drastic decrease in activity. Getting the weight out of control is the last thing we need.
DIY compounding
I wanted Cookie to start her herbs as soon as possible so while we were waiting for the capsules to arrive, we got creative.
We got gelatin capsules from our local pharmacy, emptied the gelatin and filled them with the herbs. Not fun but worked well in the bind.
You can read more about DIY medication compounding here.
It is a big difference for me, giving Cookie NSAIDs or giving her the herbs.
With NSAIDs, I understand why she needs them and I hope that they won’t do any harm. With the herbs, I’m excited about all the good things they can do for her.
Cookie’s favorite part of the treatment plan is laser therapy but about that next time.
Related articles:
Canine Iliopsoas Injury: A Common Undiagnosed Injury in Dogs
Cookie’s Iliopsoas Injury: The Symptoms
Canine Iliopsoas Injuries Symptoms: Sometimes You Don’t Even Know What You’re Looking At—Cookie’s Hind Legs Transiently Fail To Work
Cookie’s Iliopsoas Injury Treatment: Laser, Hydrotherapy and Chiropractic
Dog Recovery Chemical Restraint: Our Use of Trazodone during Cookie’s Iliopsoas Injury Recovery
Further reading:
Iliopsoas Muscle Tears: Clinical Signs, Diagnosis and Treatment