NeylasMom

Roux, do not apologize! Glad to hear you are hanging in there. Well I came home to no AC. Which is not great in a 3rd floor condo in the DC heat and humidity with a dog who runs super hot. At least it's night and not the worst weather we've had. But it's 85 degrees in here and the dogs are all panting to varying degrees despite 4 different fans blowing on us. A local company should be able to come tomorrow, buy I'm waiting for the company that installed my HVAC unit to call back to tell me their emergency fees. Its probably not worth it, we can survive until tomorrow, but I hate to see my boy panting.

I hope having Cecil's ashes at home is bringing you some peace Lori. Would love to see a photo of the urn if you're willing to share at some point. Zuri is having a high bounce day. Woke up that way, but then got his massage this morning, which always make him feel really good. Only in our house would the massage therapist and I be hanging on a futon mattress together chatting while she works on my dog. I asked her if this was the first time she could say she'd been in bed with a client, to which she said yes. We'll be going in for blood work sometime later this week. I hesitate to even say this because we're really still in day by day mode, but Z will be due for his next Zoledronate treatment a week from Tuesday provided the oncologist is okay with his kidney values, which I am certainly not counting on. I was also thinking of x-raying before the treatment, but I think I will do it if we end up getting the treatment and see some improvement from it. I can't believe I'm even thinking that far forward, but we've had a good week since the Gabapentin increase. Still, 9 days is a long way off. First things first. Tomorrow I have to call the oncologist and find out how soon I can do the bloodwork and not have to repeat it again before the treatment. I'd like to take him in Tuesday since that works best with my schedule, but that's a full week beforehand and I think she's going to say no. However, they're not in on Fridays and Monday is a holiday so that makes the timing tricky. Will see what she says.

I don't know a ton about ME so I could be way off base. Did your vet tell you why he didn't think it was ME? If it were me, I would just go to an internal medicine specialist. I love my regular vet, but specialists are worth their weight in gold and since you have 2 separate issues going on it seems worth it to me. But specialists are easily accessible here, if not cheap. I realize that's not the case for everyone.

I would get thee to a vet (specialist?) asap to rule out megaesophagus. While manageable, the regurgitation can cause a very serious condition called aspiration pneumonia so you want to get on managing the disease to prevent the regurgitation asap. Hopefully that's not what's going on, but given the frequency I fear its a possibility. ME can apparently be secondary to other issues like Cushing's, which could cause the incontinence. Has she been drinking larger quantities of water/having a larger volume of urine? Is the urine dilute on the bedding (light in color, not a strong smell)? http://healthypets.mercola.com/sites/healthypets/archive/2012/10/29/megaesophagus-disorder.aspx

I'm so sorry Carol. Did you change your mind about increasing the Gabapentin or are you still going to try that? Hope you are able to keep her comfortable for a while longer. I had to work today. Z was pretty mellow when I got home though he did play a bit. Painwise he seems good. He gets another massage tomorrow, which always makes him feel really good. I don't think I told you guys about our latest home improvement for him. I really miss our couch snuggling time so I had a full size futon mattress delivered. Moved the leather chair into my spare room and put the mattress down instead. That plus a little swivel stand for the TV and we can now spend many hours of the day snuggling. Here's our new set up: He seems to really like it. Even so, I thought it could be comfier so today I stopped at Home Goods and bought a memory foam mattress cover. Have I mentioned how broke I am? Now you know it's not just his vet bills.

Oh shoot, of course. I totally brain farted on the vet issues, sorry.

Especially with Gabapentin I think more frequent dosing is better. I held off when the Zoledronate was doing it's thing because we could and it meant more sleep for me, but Gabapentin is known to have a short half life. There's at least one study that measured levels in 6 greyhounds. Peak levels were reached in about 2 hrs and then dropped off from there. I'll see if I can find the link and post it as well. We have definitely seen notable improvement just switching from every 8 to every 6 for the Gabapentin. The schedule is really tough for me with no help but it's worth it. ETA: Here it is: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891228/ And I meant to ask - do you have an oncologist? I know you don't have a definitive dx, but if you're operating on the assumption that this is cancer, you'll likely get better help on the pain management from an oncologist. You might also think about Zoledronate at this point.

Ha, I wish. That was his dose when he was doing really well from the Zoledronate. We're at 150 mg every 6 hours. But part of me now wonders how much those recent increases are helping, but I don't think backing off any meds to find out is a good idea right now either. Meanwhile, as we're now blowing through the Tramadol I realized we are going to run out of it this weekend so I called in a refill, except the vet had stupidly written the last scrip as 2 pills every 8 hours so they won't refill it yet. Commence multiple phone calls to vet and pharmacist. At one point, the pharmacist starting asking me questions about the dose, asking how much Zuri weighed, saying that would be an overdose in a human, asking who told me to increase the dose. I got pissy. Don't mess with a mama bear who's dog needs his pain meds. I hope Macy's just feeling restful today, though I have to admit I would feel slightly vindicated if another dog also experienced some sedation from the Amantadine. But I certainly wouldn't wish side effects on anyone. Oh, I meant to also include in my post above a note about varying the dose schedule so you can sleep. I'll edit my post now to include that.

Okay, so since some have asked about how I'm stepping up Zuri's Gabapentin and there was I think some interest in hearing what the in-home vet said about pain management, I'm going to do my best to summarize what she told me. With the HUGE caveat that I am not a vet and may not be relaying what she told me 100% accurately and I am not suggesting anyone make dosage changes to their meds based on what I'm saying, but perhaps go to your vet armed with additional info and have a discussion. The link that I posted on the first page is a really good resource that outlines the pain process in dogs: http://www.vasg.org/newer_options_for_chronic_pain_management.htm It's something I had read in detail many times and thus corroborated a lot of what the vet was telling me. Tramadol: The actual pain relieving component of Tramadol is a metabolite of it. In humans, a much larger percentage of the metabolites are that specific one, but in dogs it's a miniscule amount (I believe she said 2% or something along those lines). So Tramadol is not actually relieving pain in dogs via that mechanism. What it actually does is play a role in the Serotonin system in the brain, blocking the dogs pain perception. This is still useful, but if you read in detail the link above, you'll see why other medications are needed to stop the actual pain process. Additionally at higher doses you are likely to see sedation and/or constipation. Safe doses range from 2.5-7.5 mg/kg QID (4x/day) according to my vet though I have read as much as 10 mg/kg is safe. Safe meaning won't necessarily cause harm to your dog, but doesn't mean you won't experience noticeable side effects. Gabapentin: Gabapentin on the other hand basically has no limit in terms of safe dosages. She told me she had a Newfie (granted, a very large dog) that was up to 2100 mg PER DOSE! The potential issue with increasing dose is side effects, but typically those (generally just sedation) resolve in 3-5 days and she also had suggestions for how to increase the dose to mitigate those. So instead of what I had been doing, which is increase all doses at the same time, she suggested started with the nighttime dose. So if you were giving 300 mg every 8 hours at 8 am, 4 pm, and midnight and wanted to go up to 400, you would do 300 @ 8 am, 300 @ 4 pm, & 400 @ midnight until you saw the resolution of any side effects. Then you might do 400 @ 8 am & midnight and 300 @ 4 pm and then finally 400 for all doses. For us, this time around we were changing frequency, not dose. So I had been giving 400 mg every 8 hours and wanted to switch to every 6 hours. Giving 400 every 8 is the same as 300 every 6 (both 1200 mg/day) so what I ended up doing was switching to every 6 hours, but varying 300 & 400 mg doses. The only side effect we see is a little less back leg awareness. Doing the increase this way it was much less noticeable and each time I saw it had pretty much resolved, I increased another dose. So for a couple of days he was getting 300 mg twice a day and 400 mg twice a day. Yesterday I ended up just moving them all to 400 because he was doing well in terms of side effects. The other point she made about Gabapentin is that there is some evidence that the body adjusts to it over time. So in some cases, when you increase the dose, you may not really be increasing it in the sense that the dog's pain has increased and they need more medication, but rather just that the body has adjusted to the medication some and now a bigger dose is needed to get the same pain relieving effect. Amantadine: As I mentioned earlier, she hasn't seen side effects in her patients from this medication, but there are rare reports of nausea or agitation that resolve with time. Her opinion is that it's a can't hurt, might help sort of thing. It doesn't relieve pain on its own, but is thought to enhance the pain relieving effects of other medications, particularly NSAIDS so your dog does need to be on other pain meds if they're going to take this one. It is a little pricier than Gabapentin and Tramadol, but probably not cost prohibitive (especially if you use GoodRx ). It's available as a 100 mg capsule and is given once per day. She said it didn't matter what time of day you give it because it builds to an even level in the body (so you don't have to give it with the NSAID for instance so long as you give it at the same time each day). If you need a smaller dose, you can get it as a liquid. Anti-inflammatories: We didn't really discuss these because Zuri is pretty much maxed out on his Deramaxx dosage. All I will say is that an anti-inflammatory is a requirement if at all possible for pain management with osteo imo. From my limited knowledge, if you have a choice of which one to use starting out, discuss in detail with your vet the pros and cons of the various ones and choose one that you think is likely to be best for your dog long term because once the dog is on it, in order to change you need at least a 3 day washout period, which often isn't an option with a dog with cancer pain. Tylenol/Other codeine drugs: She felt Tylenol was another reasonable option to try. It's often given in combination with a codeine drug (Tylenol 3 or 4), but she said you are very likely to see sedation with those drugs so trying Tylenol alone was a viable alternative. I have read that hepatotoxicity is not thought to be an issue in dogs like it is in humans fwiw. And contrary to what some people still believe, Tylenol IS safe for dogs. It's cats for whom it's a total no go and the myth that it wasn't safe for dogs either came around because people thought it would be easier to just say it wasn't safe for pets rather than risk people giving it to their cats. So after having this discussion, she suggested we just stay at our current dose of Tramadol and play more with the Gabapentin, plus add in the Amantadine. My initial reaction was, but when I increase the Tramadol I see improved pain relief to which she pointed out that he was very up and down. Having now been working at increasing the Gabapentin this week I will say that we've been holding steady with slight variation despite his level of activity, whereas when I was bumping up the Tramadol before, I was seeing little bits of improvement but as soon as he was feeling better and was more active he'd be very painful again. It hasn't been that long with the Gabapentin increase so we'll see, but so far what I am seeing corroborates what she said as well. I hope I've done a decent job of passing on what she said and that this is helpful to someone down the line. ETA: Note about sleep: At one point the issue of the timing of his meds and my sleep came up. She encouraged me to alter the timing a bit to get more sleep. Her suggestion was to give one an hour early and the next one an hour late to at least allow myself 7 hours (so the one before bedtime would come at 5 hrs instead of 6 and then the next dose would be in 7 hours then we'd resume every 6 hours for 2 doses). My oncologist had earlier said varying an hour each way was perfectly fine when we were dosing every 8 hours. Sharing that in case anyone is struggling. For us, switching the Gabapentin to every 6 hrs makes things easier because I can now go to bed earlier. That's making it a little harder to fall back to sleep after the middle of the night dose, but I think we'll adjust to that. I also tweaked times a little so instead of the wake up call coming at 2:30 am it comes at 3. I think Zuri's internal clock is still on the old schedule because he'll often wake to move beds or drink water at 2:30, which wakes me. So I think when he switches over to 3, I'll be able to sleep right up until the alarm and fall asleep easier. Anyway, for what it's worth.

Mother...!! I just typed this whole long post and it got deleted! So here's the Cliff notes version. Carol. I'm sorry Macy is hurting. I need to give Z his meds and walk the girls and then I'm going to post what the vet told me about pain management so maybe you'll find something helpful in there. Also, it sounds like the Amantadine is the culprit of Macy's inappetance, but I did want to mention that for Z the nausea from the Artemisinin didn't show up until after he'd had his second dose. Just in case you remove the Amantadine and that doesn't resolve things. Lori, I am THRILLED to hear that Jet is back to his usual self. Continuing to send good thoughts and to you. And I totally get the work situation. I've pretty much been there the last 2 weeks and Zuri is still here. I've burned through all of my sick time and most of my vacation time so I don't exactly know what I'm going to do when things get worse again. I'm not even sure who I'm going to bill all of this week's hours to. Hang in there. Quick Z update - he's doing well today. I've decided that how well he is doing is defined in terms of his level of "bounciness". Bounciness on walks, as in he's trotting ahead and sometimes pulling to get to things and bounciness inside in terms of running around playing with his toys. This morning was full on bounce. He ran around with a toy when I called him to get up to go out for his walk and then on the walk he was doing little spurts of trotting and pulling. I was a little worried yesterday as it was his first day on the full new dose of Gabapentin and he wasn't his usual bouncy self, but I wonder know if he wasn't still getting over that sedation thing. So I decided something this week, which is that I need to give things a full day, if not 2 when there are changes (barring anything really terrible, god forbid). While this doesn't eliminate my worry completely, it does help mitigate it and it will help me make more rational decisions. We're not in a place where a day or two puts him in a really bad place so I think this will really help me. Okay, I have to medicate Zuri and get the girls out for their morning walk. I'll post again later with that med info when I get a chance. ETA: Oh Carol, I meant to say that that dream sounds horrible. Sunday night, when I thought I was going to let Zuri go on Monday I didn't really sleep at all. The little pseudo sleep I got was filled with dreams like that. I am dreading having to go through that again.

Did you do a urine culture to ensure you were using the correct antibiotic?

So my vet claims that sedation is not a noted side effect of Amantadine in dogs and I have read that's true (nausea and agitation are the two you read about), though sedation is a side effect in people. But I am here to tell you that Zuri was knocked out for 24 hrs straight after the dose I gave him. I was really concerned because he wasn't even getting up to drink water. Once up for his walks he would trot around and seem okay, but once inside it was back to bed and dead to the world. But he got up happily for dinner last night and then perked up. Even when he was sleeping I could tell the difference. Instead of just laying prone completely unmoving he would occasionally change position a bit and he was dreaming. He'd also occasionally wake up and look alert and normal. By bedtime he was definitely his normal self and he's fine today. So unless I learn otherwise somehow I'm going to assume it was the Amantadine. Sharing this only to recommend that if anyone is thinking about using it, you might want to make sure you get the tablets so you can split if desired. It doesn't seem to come in other doses and what I got was more of a gelcap so I can't split it. Its not horribly expensive, but it's not the cheapest med either. I think I paid $30something with a GoodRx coupon for a 30 day supply. I'm going to ask the vet for a new Rx I guess and try again with 25 mg once we're done upping the Gabapentin. I increased another dose last night so we only have one to go.

I'm sorry. It has to be so difficult thinking that and not knowing. Roux, thanks for sharing your experience. It honestly doesn't sound like you could have gotten much of a headstart on her treatment based on your description. With Neyla, there really were no warning signs. She was her usual active self, then one day she just came up really lame and I knew immediately what it was. With Zuri, I definitely saw a decrease in his energy level on walks. I would have to do a lot more coaxing for him to walk at our usual (already slow) pace. I remember thinking half-jokingly one day as I would encouraging him to hurry up, "When you find out he has cancer you're going to regret this". But this was a gradual decline over a few weeks or months and I thought it was most likely his LS. He never actually showed any lameness in that particular leg, at least that I could see so I'm not sure what I could have done. We had been to VOSM for an LS recheck in December. I suppose I could have taken him back and had them redo his gait analysis. Maybe something would have shown up pointing to an issue with that leg and we could have x-rayed sooner, but they were already so wishy-washy about cancer being visible on the x-ray when we got it. And it was the sudden limp on top of the decline that convinced me and made me resolute that that was what was going on and caused me to pursue further diagnostics with the oncologist. So I'm not really sure I could have done anything differently. It's definitely worth sharing this information though for others. The one thing I do believe is that ANY time a limp shows up suddenly in a grey (with no obvious cause like a slip or fall) that you x-ray and pursue a diagnosis. Never just do rest and anti-inflammatories and "see if it improves" because typically if it's osteosarcoma it still will. Until it comes back and then you've lost a lot of potentially good treatment time. But in your case Miriam, not that much time had passed so I really don't think you could have done anything more. Today's Z update: I am alternating 300 & 400 mg doses of the Gabapentin on the new 6 hr schedule to help him adjust and that seems to be going well. He's trotting on his walks and wanting to go further and is back to getting around a lot better and not seeming to have setbacks if he runs and plays. I added in the Amantadine last night and what followed was a dog that was knocked out all evening/overnight into this morning. So I will be holding off on giving that again to try to ascertain if that's what caused it and I sent an email to the vet to see if it's possible to get the medication in a smaller dose so if we do reintroduce it we can do it more gradually. But I'm pleased with how the increase in the Gaba is going so maybe we can hold off on the Amantadine for a bit. A plus - I got the dogs settled into the bedroom for bed last night and then went to do one last thing. When I came back in I had a moment of alarm when I didn't see Zuri on his dog bed or in his crate until I realized he was in my bed. He slept with me all night.

If he really needs to set a vet and you're going to adopt him and end up paying for it anyway, why not just take him? Or just tell them if the cost is the issue you're happy to pay for it to get their approval. Frankly, my opinion of this group drops with every post though I realize I am only hearing things from your perspective.

I wouldn't work on basic cue training until you have addressed the fear issues. However, what I would do is try a variety of very high value food to take on walks and see if she will eat any. Cooked chicken breast is a good one (you can buy canned chicken and rinse it to keep it simpler). Cheese, lunch meat, especially roast beef though preservative free turkey breast or ham will work nicely too, hot dogs cut into tiny pieces and microwave are all worth trying. Anorexia is a sign of anxiety, but you may find she's willing to take the higher value food. You might even initially have to gently push it into her mouth, but if she doesn't spit it out, great. So you could go out, walk to the end of your street feeding her like that, let her potty and then immediately return home. If you have a yard that she's more comfortable in, I might just stick with that until she warms up more. Composure chews are easily found online, Amazon sells them. You can safely double the dose if you try them and notice a small difference. L-theanine is marketed as Anxitane in a dog chewable, but it's pricey and hard to find so I would just get a human supplement. Most greyhounds are large enough to have a 100 mg capsule twice a day. You want ot make sure the one you buy does not contain Xylitol (poisonous to dogs) and is pure Suntheanine. This is the one I use: https://smile.amazon.com/Enzymatic-Therapy-L-Theanine-Vegetarian-Capsules/dp/B0017KHVM2/ref=sr_1_1_a_it?ie=UTF8&qid=1472057153&sr=8-1&keywords=enzymatic+therapy+l-theanine Composure contains a smaller amount of l-theanine so just try one or the other at first. Both can safely be used with DAP. There's another option called Zylkene, but it's a bit pricier so I usually recommend trying the others first. If you want to try DAP, I prefer the collars, which are also available online for much less money. The puppy & small dog one fits my male greyhound, but you can measure to be sure: https://smile.amazon.com/Appeasing-Pheromone-Collar-Puppies-Small/dp/B000HPVH6O/ref=sr_1_1?s=pet-supplies&ie=UTF8&qid=1472057215&sr=1-1&keywords=dap+collar

Sounds like her fear outside is causing her to avoid coming to you when she thinks it might result in going out to the scary place. You might need something to help her along so her fear doesn't worsen further. There are some natural calming aids you can try first. In addition to DAP, which I find is better for separation anxiety/distress, there's also Composure chews or l-theanine. I would start there. If she's not eating Thats a good sign that she's darn scared. Please also make sure your trainer uses reward based methods only. Avoid anyone who calls themselves a "balanced" trainer or says they use methods that suit the individual dogs. Ask specific questions like what will happen if my dog makes a mistake, do you use any corrections, etc. If you have any doubts or something feels off, abort! Punishment will make her so much worse.

Get the x-rays to be safe. You might want to x-ray up to the shoulder. But I wonder about a foreign body in a paw pad. You might want to start doing twice daily Epsom salt soaks. Supposedly can draw out foreign bodies.

This put a huge smile on my face. Love imagining him demanding things from you. Zuri barks (loudly and at a very high pitch) when he needs something. I liken him to a baby - if he's hungry or has to pee or poop he barks. His newest is when he wants to lay on a certain bed, but something like a food bowl or kong is in his way. So I guess we can add tired to the list. Anyway, I love that he and Cecil had that routine/demand thing in common. Thanks for checking in and sharing when you're feeling so raw. I can totally feel your pain through your words and my heart breaks for you. I've been there and it's so tough. Just try to get through today, and then the next day. At some point something will bring you a small amount of joy again. Please don't hesitate to post in here as often as you need. I was never able to write remembrance posts for Neyla or Cisco. It really upsets me that I never did it for Neyla. She was my first dog and my heart dog, but I just could never do it so I will totally understand if you can't, or need to wait. And I sincerely hope nothing more serious is going on with Jet. Please let us know when you get the blood work results. I imagine it's been a very stressful time period for all so he may just need some time to adjust to the new normal as well. Miriam, I think you should add a new family member as soon as you are ready! Everyone's timeline is different. I have no clue of whom you speak.

Mer, someone commented on that on my cheeseburger video too. He's always been very gentle about taking treats and food, at least that I can remember.

Does it only take off dead fur, or do you find it's pulling out hair when you remove it (and thus might be uncomfortable)? I'm going to ask Z's massage therapist about this. She works with horses as well so may have some experience. He certainly could benefit from some more awareness of his back feet, as well as help along his spine in terms of muscular/neuro stuff. I sent Zuri's rehab/massage person an email - will update in here if anything comes of it. This is giving me an idea though. For the shepherd with the back foot scuffing, I wonder if applying vet wrap around the back legs just above the ankle would accomplish the same thing? I may try it.

So last night I said to the in-home vet, I really need Violet not to get osteo because I really can't handle 3 dogs in a row and her response was, "But you're so good at it." I appreciate that she has a sense of humor. Honestly though, please no. Though of course I imagine any terminal illness or cancer is tough to deal with. I happen to think osteo is particularly nasty, but it's also the only thing I've had to deal with - other than Cisco's mouth cancer, but that wasn't a case of managing his treatment because once I learned he had it, I knew I had to let him go. Anyway, all of that to say that I think it's impressive that you have that perspective after going through this with Crouton. Shows how strong of a person you are. I'm glad you enjoyed seeing him eat his eggs. I happen to think he is the handsomest man around, especially now that he's so white, but I may be biased. I'll have to dig up an old photo from when I adopted him. He was jet black, you won't even recognize him. ETA: Here he is. My boy, not even 2 years old yet Cool, thanks.

Interesting. I'd love to try this for Zuri's LS.

Zuri and I shared scrambled eggs for breakfast this morning:

Stalk away. I appreciate that you guys care enough to check in. Glad Macy is doing well overall. The not knowing would be really tough for me so I can certainly understand that. Regarding the couch, Zuri continued to jump into the couch for a while after his diagnosis, but was already beginning to struggle with jumping into the car, which I guess was higher. I think with the decreasing exercise as a result of his cancer, he lost more muscle tone and eventually stopped getting on the couch. Its one thing that really still bums me out because we often snuggled together, but I have been finding other ways to do that on his beds on the floor. Its not the same though. We used to snuggle up for naps alongside each other. Chris, could you add this link to the original post? Its one of the best I've found regarding oral medication options with details about dosing that seem more appropriate for cancer: http://www.vasg.org/newer_options_for_chronic_pain_management.htm Lori, thinking of you. Quick Z update - he's still feeling good, but the Gabpentin is definitely causing some noticeable back leg stuff. I'm an idiot. The vet and I discussed how to increase dose moving forward gradually, and I started to ask about how to do that in this case, but stopped myself because it was a schedule change, not a dose change. But duh, the answer is to lower the dose on some of them. So he was getting 3x400mg, which is 1200 total. I went to every 6 hrs so instead of doing 4x400, which is 1600, I should have done 4x300-400 with only one or two doses at 400 to start. So I had this revelation after his morning dose do I'm going to only do 300 at his afternoon dose. Annoyed because I would have prefered to cut the AM back, but this is the stupid stuff I tend to do. In other news, one application of hydrocortisone before bed has made a huge difference to the butthole. Zuri hasn't tried to lick since. We're Epsom salt soaking right now and then I'll reapply. I'm worried about when I have to leave to teach tonight but hopefully it's feeling so much better by then he's not interested in it. But it's amazing that I had convinced myself it was something more serious and indicative of his body quitting on him and was factoring that into my euthanasia decision. Very glad I decided to just find out what was actually going on.

He's on 400 mg Gabapentin and we just switched from every 8 hrs to every 6 hrs. There are a lot of details about the pain meds that I didn't share because I doubted anyone would want to read the novella as it is but I'm happy to try my best to share what she said accurately in case it's helpful moving forward for you or anyone else. And thank you, that's good to know about Mork and the Amantadine. How is Macy doing?