Pain Patch And Pain Meds?

[Guest JohnnyBell]

Most of you know Sophie had her back leg amputated on Tuesday. Well we had to take her back to the vet on Saturday cause her wrapping was sliding off, so the just removed it and also replaced her Pain patch with another one.She seems to be acting alittle wierd since then, she's panting and pacing like she doesn't know what the heck to do with herself.Do you think this is normal?? she couldn't be having a reaction to the patch since she was ok with the first one, right???My poor girl... since they took off the wrap her amp site is kinda draining alittle,is this normal???She is also on Tramadol and Carprophen for pain.

[Guest longdogs]

The patches don't work instantly. Body heat activates the flow of the drug. When we used them (Fentanyl / Durogesic) on Nugget we found a few problems during the changeover. First the old patch needed to be removed while there was still some life in it and the drug levels hadn't started to decline, then the new patch took about 18 hours to reach full flow. During that period she obviously felt more pain and was more distressed. We got over this by giving her shots of morphine. You have to be very careful to check exactly what painkiller is being given because a vet, other than her usual vet, gave her a painkiller (not morphine) that works fine by itself but actually stopped the Fentanyl from having an effect. Poor Nugget hated the whole process. She didn't appreciate her fur being shaved for the patches and they were terrible to remove. You aren't supposed to use solvents and her skin was very tender indeed under the patch. Unlike Sophie (I have my fingers crossed for you) she had no prospect of recovery and we brought things to a close while she still had a few moments of lucidity between drug-induced torpor and the pain of patch replacement. She was amazing right up to the very last minute.

[Aerosmom]

I'm not sure because Snickers had a pain patch only before the surgery, but she seemed to notice when it started working because she would turn and look at it. What longdogs said about there being a drop in the drug level until it works makes sense. Snickers panted a lot and seemed agitated for at least the first three to four days home, especially at night.

 

It's really hard at first. We're one week from surgery and it's finally getting a little better.

for Sophie

 

for you

[Burpdog]

Some dogs cannot tolerate the pain patch. If she continues to be agitated, ask the vet about removing it. The amp site should not be wrapped. Some dogs have severe reaction to the tape and it irritates when they walk.

 

Sending prayers!

[Guest mybabies3]

My Millie reacted the same way with the Fentanyl patch. She was extreamly agitated and unsettled. Once we go the ok from the vet to remove it the next problem was getting it off. When the patch was removed within 6 hours she was fine. The vet had warned us that this kind of reaction may happen. Millie was much happier once the patch was off. He told us that if she still needed something for pain he could perscribe oral pain meds.

[DaisyDoodle]

The patches don't work instantly. Body heat activates the flow of the drug. When we used them (Fentanyl / Durogesic) on Nugget we found a few problems during the changeover. First the old patch needed to be removed while there was still some life in it and the drug levels hadn't started to decline, then the new patch took about 18 hours to reach full flow. During that period she obviously felt more pain and was more distressed. We got over this by giving her shots of morphine. You have to be very careful to check exactly what painkiller is being given because a vet, other than her usual vet, gave her a painkiller (not morphine) that works fine by itself but actually stopped the Fentanyl from having an effect. Poor Nugget hated the whole process. She didn't appreciate her fur being shaved for the patches and they were terrible to remove. You aren't supposed to use solvents and her skin was very tender indeed under the patch.

Ditto what longdogs said with a couple of more details and questions.

 

Heat--you don't want a dog to get overheated w the patch on because heat will increase the drug delivery rate and could possibly cause an overdose. So, don't put Sophie in extra-warm pajamas or anything like that. I'd use a T shirt to keep her away from the patch and/or surgery site, but nothing heavier. Don't leave her lay out in the sun too long, etc. Watch her temp also to make sure she doesn't run a fever.

 

Keep an eye out for lethargy and slow respiration, which are signs of overdose. If you have a really hard time waking her, call the vet.

 

Panting, on the other hand, could be a sign of pain (not enough drug in the system for the moment) or possibly of nausea, as fentanyl can cause that as well. Since they had put the first patch on Sophie on Tuesday and it's only supposed to last three days (on humans anyway), then her system was probably pretty much out of it when they removed the old one.

 

When it comes time to remove the last patch, I'd suggest you just leave it on until the adhesive gives up its grip. If you do want/need to remove it, use something oily; don't use alcohol as it can drive more drug into the skin if there is any drug left.

 

Question for Longdog--which pain drug were you speaking about that can block the fentanyl? Narcan (naltrexone) is used to reverse the effects of fentanyl (and should be used immediately by a vet if an overdose is suspected, along w removeal of the patch), but otherwise my local expert can't think of any drug that can block the absorption of fentanyl.

[Guest longdogs]

Question for Longdog--which pain drug were you speaking about that can block the fentanyl?

 

I'd have to dig into my records, it wasn't Narcan. As soon as I called her specialist he told me there was a problem with the combination.