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Help! Snickers Is Screaming -- Is It Phantom Pain Or What?


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It's almost two weeks post-amputation for Snickers and she's been on

Tramadol 2 x day since coming home from the vets about 11 days ago. Her

stitches were removed on Tuesday, and she had her first chemotherapy at

the same time.

 

I've heard from other greyhound owners and read that the screaming might

be a reaction to the Tramadol. I'm really getting stressed out about

this because I thought the amputation was supposed to alleviate the

pain. It's tearing me up inside to hear her cry like this. It seems to

be most frequently when she stands up, but sometimes she'll just scream

for no apparent reason. The episodes last for a very long 10 seconds or

more.

 

I withheld the Tramadol this a.m. because I thought if it's phantom pain

it won't help and I wanted to see if she did better without it. I

haven't noticed much difference so far and just broke down and gave her

one because I thought maybe she is having muscle spasms.

 

I've asked the surgeon about this, and they have witnessed it, and I've

just been told that they can't find a focal point for the pain and for

me to continue with the Tramadol 2 x day for another week. No one seems

particularly concerned about this.

 

I think at this point she has five or more of these episodes a

day/night. It's making me feel very guilty for putting her through all

this when it was supposed to help her.

 

Any experience/advice is much appreciated! I've been trying to research

online and haven't found much info. I also e-mailed Dr. Couto's group

and they said that the typical bad reaction to Tramadol is more delirium

and a consistent reaction, not these sporatic fits.

 

It tears at my heart everytime I hear her cry like this. My worse fear

is that there is cancer somewhere else in her body that is causing her

to scream.

 

I also posted this on Circle of Grey -- I'm hoping someone has some experience/advice about this.

 

 

 

 

 

 

 

 

Aero: http://www.greyhound-data.com/d?d=kees+uncatchable; our bridge angel (1/04/02-8/2/07) Snickers; our bridge angel (1/04/02-2/29/08) Cricket; Kanga Roo: oops girl 5/26/07; Doctor Thunder http://www.greyhound-data.com/d?z=P_31Oj&a...&birthland=
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Max had it for a few days and that is the reason I knew to mention it to Glynis. I don't think it's the tramadol but phantom pain.

 

Phantom pain, also called deafferentation pain, anesthesia dolorosa, or denervation pain, is pain that is felt in a part of the body (usually an extremity) that either no longer exists due to amputation or is insensate as a result of nerve severance. It is often described as a burning sensation, though individual accounts vary. This pain does not originate from the limb itself, as such would be impossible in these cases, but is instead the result of the brain receiving messages from the spinal cord which it interprets as pain coming from the affected limb. [1]

 

So phantom pain is not phantom, but real pain caused by nerves. I cannot remember what we did for Max. I think it was tramadol only. Trying to get ahold of Kathleen.

 

It didn't last long. Can you tell if she is having any muscle spasms?

Diane & The Senior Gang

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Max had it for a few days and that is the reason I knew to mention it to Glynis. I don't think it's the tramadol but phantom pain.

 

Phantom pain, also called deafferentation pain, anesthesia dolorosa, or denervation pain, is pain that is felt in a part of the body (usually an extremity) that either no longer exists due to amputation or is insensate as a result of nerve severance. It is often described as a burning sensation, though individual accounts vary. This pain does not originate from the limb itself, as such would be impossible in these cases, but is instead the result of the brain receiving messages from the spinal cord which it interprets as pain coming from the affected limb. [1]

 

So phantom pain is not phantom, but real pain caused by nerves. I cannot remember what we did for Max. I think it was tramadol only. Trying to get ahold of Kathleen.

 

It didn't last long. Can you tell if she is having any muscle spasms?

 

I don't think she is, but she seems to scream most often when she stands up. She's not that active either, which could be because she had the chemo on Tuesday and it's very hot here today....

 

If the phantom pain is actual nerve signals, is it treatable with Tramadol? It seems as if the episodes are not decreasing in frequency either.

Aero: http://www.greyhound-data.com/d?d=kees+uncatchable; our bridge angel (1/04/02-8/2/07) Snickers; our bridge angel (1/04/02-2/29/08) Cricket; Kanga Roo: oops girl 5/26/07; Doctor Thunder http://www.greyhound-data.com/d?z=P_31Oj&a...&birthland=
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Possible re the chemo. I assume you saw the post about the drug she was given? Dr. Couto has not used that drug in years. Made Winslow very ill. Let me ask Glynis if Winslow had any screaming.

 

Since tramadol is an opiate, I think it should help. You might ask if morphine can be added if it doesn't subside in a day or so.

Diane & The Senior Gang

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It breaks my heart to read this...it must be just horrifying for you to hear her scream of pain and not to be able to

help her...I have no advice, I only wish that her pain will go away very soon...

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Guest MorganKonaAlex

I posted this to CircleofGrey too.

 

We had to use a combination of medications to control the pain;

Tramadol alone wasn't enough. For Alex (74 lbs). we used:

- 100 mg Neurotin x 1 day

- 75 mg Rimadyl x 2 day

- 50 mg Tramadol. Can increase up to 100 mg. 4 x day.

First increase the number of doses per day.

 

You should ask about adding Neurotin. It really helped. I can never remember how to

spell the generic name of Neurotin (Gabapentin ??).

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Guest VelvetEars

I don't know if you can get ahold of some lavender Essential oil, but if so - mix about 10 drops in 3 oz distilled water and 1 oz high proof vodka or everclear in a small spray bottle. spritz it over her to help her relax. you can also add a few drops of EO to a tealight diffuser with a little water and keep that in whatever room she's in. you can also put 1-2 drops of EO on her bed. it can help with her relaxing.

 

clary sage is a good EO with anesthetic properties - same methods as above.

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Guest gottaluvgreysindy

Deuce's screams weren't yelps, they were screams too and lasted just as long as you are describing. And after stopping the tramadol, no more terrifying screams. I'm sure I talked about it in a post somewhere. Let me see if I can find it.

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Here is one of your posts but it looks like he was still having some screamies:

 

We are still fighting through this phantom pain. It will just be two weeks tomorrow since amputation so I'm saying prayers and hanging in there. It is quite the scare when he screams like he does in middle of the night. I am up waaayy too late tonight packaging up things needing shipped out from the auction that was an awesome success thanks to all of you. Chemo is scheduled for Monday and at this point he is only on antibiotics, no pain meds right now. Thank you all for your continued support and prayers. You're the greytest!!!!!!

 

http://forum.greytalk.com/index.php?showto...44441&st=40

Diane & The Senior Gang

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Guest gottaluvgreysindy

thanks Diane for finding that. That is what I recalled, we had stopped the pain meds before he got his stitches removed and before chemo and he was on antibiotics for the infection of the incision at one point. It took a few days for the tramadol to work its way out of his system, but once we stopped the pain meds (per Dr. Couto's suggestion) he stopped screaming.

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Guest LynnM

I haven't read all the responses, so I don't know if this has been mentioned. If it has, apologies for the repetition.

 

One other possibility is that she's having pain in her back. All of a sudden, she has to bear most of her weight on one side of her body. That can throw a spine out of whack until the muscles needed to compensate develop. You'll be able to tell easily enough... run your fingers down her back when she's standing up. If you get a good flinch, then that's at least part of your problem identified right there. Talk to your vet about adding a muscle relaxer to the pain meds. It'll help her be comfortable and rest easier. Also discuss some massage techniques so that you can work out some of the inevitable muscle spasms.

 

Lynn

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Guest JohnnyBell

:bighug I also posted this on CoG.

I am so sorry you are going through this.I know that scream and it

just makes my heart sink and break in a million pieces.Mabe like you

said it's muscular.I have heard that 2/3 of the weight is on the

front legs.Mabe she's still having trouble distributing the weight

when she gets up or the internal stiches are pulling.Sophie was on

the tramadol for a week and I didn't notice any reaction like this.

I hope this gets better soon.I feel your pain:(

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I am so sorry. Sending calming and healing thoughts. :grouphug

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I would ask the vet for a Fentanyl patch in addition to the Neurontin mentioned before. The patch is changed every 3 days & will cover her until the Neurontin kicks in. It takes times to work (well at least in humans). The Fentanyl is heavy duty stuff but it seems to me it is called for.

Patty

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If they feel it is phantom pain - nerve pain - then ask about gabapentin as well as the tramadol. It is often more effective for nerve pain and for sure that is real pain.

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Poor Snickers... My heart goes out to you and to poor Snickers. I hope you can find relief soon :hope

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Possible re the chemo. I assume you saw the post about the drug she was given? Dr. Couto has not used that drug in years. Made Winslow very ill. Let me ask Glynis if Winslow had any screaming.

 

Since tramadol is an opiate, I think it should help. You might ask if morphine can be added if it doesn't subside in a day or so.

 

She was given Carboplatin. I think the drug that made Winslow sick was Cisplatin. So I don't think it was the chemo.

 

She's still having the screaming episodes -- and they are actually way longer than 10 seconds. I think it's primarily after she's been lying down for a while. A few people have suggested muscle spasms/pain, so I'm going to try to massage her legs and back and see if that helps at all.

 

Does anyone know massage techniques for a grey? I'll try to do a web search too.

Edited by Aerosmom
Aero: http://www.greyhound-data.com/d?d=kees+uncatchable; our bridge angel (1/04/02-8/2/07) Snickers; our bridge angel (1/04/02-2/29/08) Cricket; Kanga Roo: oops girl 5/26/07; Doctor Thunder http://www.greyhound-data.com/d?z=P_31Oj&a...&birthland=
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do you have access to a fax machine? i can fax you the small booklet called "canine Massage", which i got at dewey last year. let me know.

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Whether the surgeon can find a focal point for the pain or not, were she my dog, he'd be giving her more than tramadol.

 

We used tramadol for Vinnie when he had the spinal tumor. (We thought was a back injury in the beginning.) We were piggy-backing metacam and amatryptaline (sp) for weeks, and the new tramadol study had just come out, so my vet wanted to try it alone. In Vinnie's case, the tramadol was not enough. By the time I began adding the metacam, it was too late and the pain had taken over.

 

Good luck with this. I hope you can get her settled down and painfree.

Sending hugs,

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Massage would be good. Just massage--don't worry about how :) Something is better than nothing. Pay attention to whether you feel the muscle quiver/twitch.

 

I'd research the chemo drug being used and also email Ohio State if you have not. Here is a good link explaining the chemo drugs:

 

Chemo Drugs

 

Also, I don't think Max was on anything 2 weeks post op. I'll try & get ahold of Kathleen. The drug mentioned for phantom pain in this thread sounds great!

Diane & The Senior Gang

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