Long Term Pain Meds

[Trudy]

I was going to jump on Heather's thread, but decided for my own.

I'll be taking Ryan to the vet on Tuesday if I can get an apt. He's just not doing well at all. And nothing I can pinpoint. Looking for a cause to his troubles when we go to the vet and fully expect her to send us home with pain meds.

 

I have no idea if he's in pain. He never shows it. Only time he's ever let us know he was hurting is when he had that huge clot in his neck 3 years ago and screamed bloody murder when he had to move. Stick through is foot - not a peep. So general day to day pain that can come with old age... I have no idea. He pants a lot, but it's hot for him. He likes 50's not 80's. So his panting is explained... he stops when he's cooled down a bit.

 

For the last 10 days or so, his back feet have been swelling up. One or the other or both. Icing and laying him upside down while icing so his legs are up helps, but then the fluid just drains to a spot closer toward his hip and then slowly goes back to his feet when he's not upsidediddle.

 

One foot does seem to hurt - I get the evil eye now and again when I touch it. And as a result of fat sore feet, he's having more issues with the dog door. I rescued him a few times during the night, once with pretzel legs, no wonder he couldn't get out on his own.

And now for the last few days he's been squiring up a storm and I haven't seen him eating poop, so his normal pudding poop reason seems to be ruled out.

 

Need to figure out if any of these things are connected and if any have a cause or if he's just old before old should set in.

 

But last time we were at the vet a few weeks ago, she'd asked if we have him on anything for pain, so I expect her to send him home with something. And I sort of expect it to be a long term solution.

 

Is there something we should be looking at for long term use over another. I have tramadol here from when T was neutered, so it is still good. Any point in giving Ryan some of that now until we make it to the vet or just wait until Tuesday?

[Guest Swifthounds]

How old is Ryan?

[Batmom]

I'm not a fan of giving meds without vet OK first but if you read up on Tramadol for any possible counterindications re his clotting/fluid pooling/circulation issues, I can't see that there'd be harm in giving him a small dose. Tramadol is generally pretty safe and doesn't interact with much. Some dogs don't react well to it -- it's like they're stoned and having hallucinations -- so I would probably start with something like 25mg every 6 hours and see if that brings him any relief.

 

I'm sorry he's not well.

[Trudy]

10, will be 11 late this summer. How he's doing now doesn't bode well for him seeing his 11th bday unless there is a treatable underlying cause

He's been old since he was 3 though. Always been my little old man.

 

I'm not a fan of giving meds without vet OK first but if you read up on Tramadol for any possible counterindications re his clotting/fluid pooling/circulation issues, I can't see that there'd be harm in giving him a small dose.

 

 

 

 

He was doped up on Tramadol when he got sick 3 years ago. Nothing touched that pain and he didn't seem to have any side effects from the tramadol (or in conjunction with anything else he was on at the time)

[seeh2o]

Have you had blood work and a urinalysis done recently? What you are describing about his back legs/feet swelling up make me think of Dana's boy Cartier who was ultimately diagnosed with kidney disease.

[Devotion]

I've had great results using gabapentin. You can use this with other meds as well if needed. Some dogs do well on tramadol but I've just never really been convinced it helps much. and with the nsaids it's a guess as to which one your grey responds to better and/or tolerates. Talk to your vet about the gabapentin (nuerontin).

[HopeForHounds]

Trudy, where exactly was the leg swelling? How often? Is it warmer than the rest of him? Change in colour? One at a time, or both at exactly the same time?

 

Did you ever do a tick test on him?

 

I've used metacam for long term. I like it, as long as the dog tolerates it, because you can tailor the dose to your dog. It's liquid and you give as low a dose as needed and then add more if it doesn't work, staying within the maximum dose of course.

[Tallgreydogmom]

We have all older greyhounds. I was purchasing the liquid Metacam from the vet for an arm and a leg. There is a thread somewhere not too long ago that put me onto Maloxicam 15mg Tablet thru Wal-Mart Pharmacy with 30 tabs for $4.00. I have our vet call in the scrip. Next time I will have him call in the 90 day supply for $10.00.

 

I gave them 1/2 tab (7.5mg) a day. They all seem to be doing well on the Meloxicam.

[Guest Energy11]

Hey Trudy... Fluid retention can be indicative of lots of things, including Kidney Failure and Cardiac related issues.

 

If you think Ryan is in pain, and this swelling continues, I would probably see the Evet. Thisway, you can get some labs done and see how the kidneys are functioning, and be sure there isn't fluid accumulating in Ryan's lungs, as well as his legs.

 

I am sorry he is going through this, and hope he feels better, SOON! Once they determine the cause of the fluid build up, there are meds they can give to help eliminate them.

 

Sending hugs, prayers and good thoughts! Dee

[Batmom]

Since he's had it before and not had a funky reaction, you could give him a 50mg. I'd probably start with every 8 hours at that dosage, until you've seen the vet.

[Guest GreysAndMoreGreys]

Trudy can you give the back history on Ryan.

Seems like it all is some how related but how it's related is the million dollar question

 

IIRC he is on Pred? I think over time that can cause fluid buildup.

While I wouldn't say he seems like he's in pain, he does seem like he might be uncomfortable. Like "I don't feel all that well." But then again it's the first and only time I have met Ryan.

 

And while I think if a dog is in pain they should get pain meds, I also like to know why they are in pain and see if there is a way to fix or control that. Thinking that is where you are at on this with Ryan too.

[PatricksMom]

I like Tramadol for pain, but given the fluid retention, I'd call the vet first even though he's been okay with it before. If he has kidney problems, he will retain it in his system longer, so the dose will need to be adjusted, the same with liver issues.

 

http://www.drugs.com/cons/tramadol.html

[TheFullHouse]

Saint had an episode of swelling of the back legs but it happened when he wasn't feeling well and just lay around on a bed all day. I was really worried, took him to the vet and our vet thought it was from laying down all day and not getting up and moving around. He was right, as soon as Saint was feeling better and up and moving, the swelling went down. Don't know if it's the same with Ryan or not but thought I'd throw that out there.

[Trudy]

We've been watching his kidneys for 3 years and I think that is what some of this is going to come down to again.

 

Did bloodwork maybe 6 months ago and his values were perfect for everything.

Did more bloodwork 3 months ago and his values were still great, but kidney values were creeping up a bit. I'm guessing we'll see that value higher on Tuesday.

 

 

Ryan's back story:

3.5 years ago it took us 20 minutes to walk around the block, something that would normally have taken about 4 minutes at a leisurely pace. The day prior we'd done a nice long walk and had to stop at about 2/3s of the walk so Ryan could lay down and rest. He was dragging. Then it was a very leisurely walk home. He'd also yelped when Jet ran into his chest.

So we brought him to the vet and determined he was having some issues with his neck. Sent home with some pain meds and injected with a steroid before we left for the weekend. Monday came and he was yelping when he was getting up or laying down. Back to the vet and not something he would be able to identify, so sent to the specialist. Consult on Tuesday, she put him on pred and gabapentin. I had to stop at the vet on the way to the specialist for pain med injections just to get him to the hospital. Return Wed for an MRI, she was positive he had cancer. MRI that evening and instant bleeding ulcer from the pred, he had to stay overnight at the hospital. She was still convinced it was cancer even though nobody saw anything indicating it on the MRI. The MRI did show a 8" long clot in his neck that was in a place NOBODY could figure out how a clot would get there. I told Ryan to give me a few days to get his pain under control as we tried to figure out what was causing this. If we couldn't get the pain in control, I'd let him go.

He endured 2x daily trips to the vet for pain med injections for a couple of days as well as tramadol and gabapentin. He was able to finally move without screaming, so we kept on going to find out what was causing his problem so we could fix it. An ultrasound revealed his body was FULL of clots. Veins to his kidney and liver were almost entirely occluded - full of clots. His spleen was looking to be an issue, but there wasn't a vet around willing to try to do any surgery on him for fear of him bleeding out on the table. We were told if he made it the weekend, it wasn't his spleen.

He had several seizures during that time even with being on 3 seizure meds since his body just wasn't able to get and process the meds due to all the clots.

We finally gave up searching and just treated the symptoms as they came and eventually, that clot in his neck broke up on its own and didn't make its way to more dangerous places. He peed out protein faster than his body could make it, and still does, though not nearly as bad... instead of off the charts with his values, he's just at the high end and has been for 3 years.

His body shape changed overnight and he was a perfect picture of a Cushings dog. Yet he isn't. He swelled up big time in the abdomen and was full of fluid which couldn't be removed, it had to go on its own - and did.

Our vet consulted with vets around the country and nobody could figure out what was going on or why and wished us good luck.

 

We continue to just treat things as they come up and look back each time to see if his issue makes any more since. It hasn't.

He looks like death warmed over He lost about 3 pounds on our trip down here. Not weight he can afford to lose. I started feeding him more... he just pooped more.

He's much more wobbly in the back end - which I attribute to rear end weakness as he's getting older.

 

So here we are again. Back to more symptoms.

Oddly enough, the swelling in the back feet started when we ran out of Derm Caps - which he's been on since he got sick since it was a ratio of omega 3 and 6 in a ratio our old vet felt was beneficial for him. The manufacturer closed and nobody is making them anymore. Our new vet said she'd find something we can use instead, so hopefully she has an answer for us this week and hopefully that will help at least a little bit.

 

 

He swells at his back foot and it will swell up into just before the hock, with the fluid sitting just below it in that little see through spot between foot and hock (see through on Ryan since he has no hair and is white).

If I put him on the couch on his back and ice, the swelling will drain down into his leg, but within an hour or two, it is back down in that thin spot.

 

 

His water was restricted during our trip - they got water in the morning, at stops during the day and when we landed and a drink before bed. Until the dog door was complete, he didn't have "all he wanted" access to the water bowl. He got lots still, but not unlimited. For 3 weeks, he's had unlimited water again. He's standing outside at the water bowl as I type. He has been able to drink gallons of water for years.

He gets up to eat, to potty and to drink (potty and drink go hand in hand... must refill after emptying ) He still gets up if you ask if he wants to go somewhere (walk, ride or a stroll around the yard). He even trotted along (he hasn't run in years) at a good clip the other day when I called him while he was outside. He doesn't 'play' like he used to, but if there is a toy near the door, he snags it during his early morning potty trip to squeak on it for a minute before laying back down.

 

 

He's not in need of an evet. He can wait until Tuesday and I know our vet will be able to get him in.

 

He's old - my old man got older again in the last week.

[TheFullHouse]

Geez, poor guy, he's been through it for sure. You're right, when you said how big his belly was and the water, my first thought was Cushings. Well you've tossed enough out there to totally confuse me too! I hope your vet has some answers for you.

[tbhounds]

If he has PLN it is possible he is retaining fluid because his blood proteins are too low. I would get him in for a chem panel. They might even want to do a quick u/s just to make sure he doesn't have abdomial ascites.

[Guest SusanP]

Just sending good thoughts--we're going through a mystery illness with our Wizard and I know the horrible feeling of watching them go downhill without knowing why or what they're feeling. Hope your vet has some answers when the holiday weekend is over.

[Guest SusanP]

Is he still on Gabapentin, or was that long ago? I was just reading up on it with Wizard in mind and see that it can cause swelling of the extremities, dizziness, and drowsiness. Just thought I'd throw that out there.

[Trudy]

gabapentin was for pain when he couldn't move his neck. Once that pain went away, he was off the pain meds.

 

All he is on now is KBr, Pb, and Enalapril

[Guest Swifthounds]

Is he on lasix?

[GeorgeofNE]

Tramadol is what my vet favors for chronic pain (and incidentally, my rheumatologist!). Very few side effects.

[gazehund]

Nobody can take better care of your old man than you Trudy so I just wish you and Ry well and hope for the best. Please keep us posted.

[Guest GreysAndMoreGreys]

Is he on lasix?

I was thinking about the lasix as well Jennifer.

 

Trudy might be something to ask the vet about. It should help relieve the fluid buildup.

And your already used to him peeing a lot so no worries there

[Greytlady94]

I'm so sorry Ryan is feeling worse. I know how hard it is for them to be old before their time, that was my Renie. Sending lots of good thoughts for Ryan, I hope the new vet can come up with a solution so Ryan will feel better.

[greytlucy]

What's he on the Enalapril for? Lucy takes this as part of a CHF regime. The panting and fluid build-up you describe make me wonder if something is going on with the heart. We see more panting in the summer heat but ultimately, in her case, the panting is due to the work the inefficient heart is doing, which is working harder in the heat. The panting then makes them thirsty, they drink more and then pee more. Assuming no severe kidney or diabetes issues. We just adjusted some meds and in spite of higher temps the panting has decreased.

 

I was amazed at the different the CHF treatment has made. She was 13 when we started it and now 14 and a half. Her back end strengthened and she was less wobbly once the drugs kicked in and her heart was working more properly and the fluid was out of the system. She also gained back a lot weight too which the heart doctor said wasn't unusual. She's back to wobbly now but for a year and a half we saw dramatic improvement and now with a new adjustment in meds we're seeing overall improvemetns, including back end again.

 

Anyway, something to think about if he hasn't had a full heart check out. Hope the vets can figure it out and get him more comfortable!

Edited May 31, 2010 by greytlucy