Osteo Thread

[greysandmollie]

We all have our opinions about what's best for our dogs, but let's try to remember that we each walk our own path and that each dog is different in his needs, personality, prognosis, reaction to disease and medication, etc. Some dogs do in fact do well on a combination of medication for a longer period of time. If I had chosen to let Neyla go at the time of diagnosis/the first sign of pain, she and I both would have missed out a half a year of quality life together.

 

Let's also try not to forget that sometimes a cocktail of meds for a period of time is what allows us to come to grips with the reality we face as owners of dogs who have suddenly been stricken with a terrible and usually fast-progressing disease. We all want nothing more than to not let our dogs suffer. And we often also have to come to terms with the fact that we will have to make that decision suddenly and/or far sooner than we anticipated. In some cases, the diagnosis is the first time we are faced with this harsh reality. And sometimes medication gives us the time we need to process it.

 

This thread is first and foremost a place for support, no matter what path we choose. While it's also a place for information, and honesty, both should be tempered with compassion. No person should feel judged for the treatment options they choose, or especially for when they choose to let their beloved dog go.

 

Jen....what a beautiful way of of expressing your thoughts...well said...

[Guest suzanne]

Freya has had a few restless nights in the last week which have meant she's needed tramadol to help her out. She sleeps in our room and has been pacing and panting and unable to get comfortable - signs of pain. The medication helps but I'm just wishing/hoping there's something we can do to stop her getting to that point. The weather has changed here in Ireland drastically and it has been freezing and stormy all week so that may be something to do with it. She's also been playing and running on her walks (a good sign surely) in the evening but that may be making her sore in the night time. Thinking of keeping her in one evening and seeing if she has a quieter night but it feels so wrong not letting her have fun. I'm so torn

 

This week, more than ever before, it's finally hit me that we're going to lose her soon.

[Guest suzanne]

It's been a few pages since pics were posted so here's a couple more of my gorgeous girl, with my lovely boy in the background in the first one:

 

 

[Charlies_Dad]

Suzanne, Freya is beautiful. I am happy she is doing okay and she seems to have an incredible spirit based on your writings.

[Guest Betsy]

Suzanne,

Love, Love the picture of Freya with the pearls! How precious! She is beautiful.

Betsy (and Taylor)

[MP_the4pack]

Suzanne, Freya is a beautiful beautiful girl. I hope your time with her is much longer than expected.

[greysmom]

Love the pearls picture - classic! Freya is soooo pretty!

[joejoesmom]

That girl can sure carry off those strands of pearls. Not every girlhoundie could rock that look. Beautiful.

 

Jane

[Guest carla7]

Freya has had a few restless nights in the last week which have meant she's needed tramadol to help her out. She sleeps in our room and has been pacing and panting and unable to get comfortable - signs of pain. The medication helps but I'm just wishing/hoping there's something we can do to stop her getting to that point. The weather has changed here in Ireland drastically and it has been freezing and stormy all week so that may be something to do with it. She's also been playing and running on her walks (a good sign surely) in the evening but that may be making her sore in the night time. Thinking of keeping her in one evening and seeing if she has a quieter night but it feels so wrong not letting her have fun. I'm so torn

 

This week, more than ever before, it's finally hit me that we're going to lose her soon.

 

Hi Suzanne:

 

I'm praying for you and Freya and hope she will be with you for quite some time yet. I'm happy to hear that she is enjoying her walks!! Persephone has also been doing the same, but during the entire walk, I am on edge as I keep thinking about the possibility of her hurting herself. In fact, I'm probably driving her and my fiance nuts because I keep saying, "ok, let's walk on the grass not the sidewalk" since I am hoping there will be less impact on her leg on the grass. Maybe you can do a shorter walk and see if she seems more comfortable at night? I have been taking shorter but more frequent walks w/my girl.

 

I love your pictures of Freya; she's beautiful, and she looks super happy in the one where she is playing with her brother!

Hugs to you,

Carla

[Guest carla7]

Hello all:

 

Today we just returned from Angell Memorial in Boston to discuss palliative tx for Persephone. She is still doing very well on just the tramadol and rimadyl, but the vet thinks that it would be wise to begin pamidronate and radiation sooner rather than later. He did a chest xray and didn't see any mets but will call tomorrow after the radiologist views the film.

 

He also wanted to d/c the rimadyl and use piroxicam as he said that this had some anti-tumor properties so we will switch to that and see how it goes. Although I am super nervous to do that as she will have to go w/out the rimadyl before the switch and although the tramadol is helpful....I think it was the rimadyl that really stopped the acute lameness.

 

So everything is pretty much status-quo here which is a good thing. He also gave me some hopefulness for maybe a little longer future with her than I had envisioned initially as he didn't see mets yet. He also said that while it was a "possibility", he hadn't seen too many dogs who actually ended up w/pathological fractures........maybe that's him just trying to placate me because he can see that I am a nervous wreck, but I am trying to get the fact that this may happen out of my mind so I am not a constant ball of stress.

 

Thanks to everyone for all the support....it really means a lot to me!

Carla

Edited September 8, 2011 by carla7

[BauersMom]

Carla - good to hear that the appt went well. We use Angell also, and they've all been wonderful there.

 

How long do they want you to go without an NSAID and just tramadol? Can you add gabapentin in the interim while you switch to piroxicam?

[greysmom]

Piroxicam is part of the OSU (post chemo) metronomic protocol for osteo treatment. It has been shown to have some tumor fighting properties. You should also ask about adding in the chinese herb Artemisinin, for the same reason.

 

Hugs for everyone!

[JJNg]

Freya has had a few restless nights in the last week which have meant she's needed tramadol to help her out. She sleeps in our room and has been pacing and panting and unable to get comfortable - signs of pain. The medication helps but I'm just wishing/hoping there's something we can do to stop her getting to that point.

How often are you giving the tramadol? I think you had mentioned in an earlier post about giving it every 2nd day? Any reason why she's not just getting it consistently 2-3 times/day? Or at least giving it earlier in the evening to anticipate the restlessness at night?

 

I'm assuming the pacing and panting are not happening after the tramadol, as that can also be a side effect of the medication. Also, what about adding gabapentin?

[Guest suzanne]

Freya has had a few restless nights in the last week which have meant she's needed tramadol to help her out. She sleeps in our room and has been pacing and panting and unable to get comfortable - signs of pain. The medication helps but I'm just wishing/hoping there's something we can do to stop her getting to that point.

How often are you giving the tramadol? I think you had mentioned in an earlier post about giving it every 2nd day? Any reason why she's not just getting it consistently 2-3 times/day? Or at least giving it earlier in the evening to anticipate the restlessness at night?

 

I'm assuming the pacing and panting are not happening after the tramadol, as that can also be a side effect of the medication. Also, what about adding gabapentin?

 

Hi, initially we were given the tramadol to give to her ONLY when she was in obvious pain. Then I made an appointment with the vet last Friday where I discussed that I felt she may need more medication (it seems every dog on this thread is on more, and more regular doses than her) and the vet recommended keeping up metacam once a day, one dose of paracetamol a day and a tramadol every second day. she was of the view that the less she can get away with, the better. We've given the tramadol as needed though. I'm really unsure as to whether she should be on a regular dosage or not.The vet didn't mention giving any extra medication, from what she said the other night, i'd say she'd say no..

 

We shortened her evening walk and didn't let her have off lead madness last night and she had a peaceful night so thats something.

[Guest suzanne]

BTw, thanks everyone for your compliments on my beautiful girl.

 

Just wondering if anyone has had any success/pain relief/stress relief/anything positive for their dog from alternative therapies like reiki etc?

[Guest snakes]

BTw, thanks everyone for your compliments on my beautiful girl.

 

Just wondering if anyone has had any success/pain relief/stress relief/anything positive for their dog from alternative therapies like reiki etc?

 

It wasn't related to his OS but I have used homeopathy for FedX's anxiety (Which triggers seizures) with good results. Rescue remedy works for him short term as well.

[NeylasMom]

Suzanne, we did do a chiropractic adjustment once that may have helped some. I think things were out of whack from her not fully weight bearing. We would have repeated it but that was when things started to progress more.

 

Carla, generally with dogs with osteo who are receiving palliative care it's not the lung mets that are of concern. Usually the pain from the primary tumor becomes unmanageable before you see signs of lung mets and that's what causes people to let their dogs go. Lung mets seem to be more of an issue with dogs who have undergone amputation and had the primary tumor removed. Not saying it couldn't happen, but I haven't heard of it.

[greysmom]

Suzanne, Dude gets a regular massage therapy session every 10 days. We initially started it to give him some relaxation, keep his muscles loose and pain free, and help keep the rest of him in line and working with only three legs. What we were not prepared for was the huge increase in his energy level and general attitude after his sessions. He LOVES his massages!!!! And we really do see a huge positive difference.

[NeylasMom]

Wondering how Twiggy is doing? Has her infection cleared up yet?

 

 

I feel like there are so many pups to keep up with these days. I hope no one is getting lost in the shuffle. Anyone who hasn't checked in in a while, feel free.

[JJNg]

Hi, initially we were given the tramadol to give to her ONLY when she was in obvious pain. Then I made an appointment with the vet last Friday where I discussed that I felt she may need more medication (it seems every dog on this thread is on more, and more regular doses than her) and the vet recommended keeping up metacam once a day, one dose of paracetamol a day and a tramadol every second day. she was of the view that the less she can get away with, the better. We've given the tramadol as needed though. I'm really unsure as to whether she should be on a regular dosage or not.

Why does your vet feel that "the less she can get away with, the better" regarding pain meds? Hate to be blunt, but when treating a terminal disease with palliative care, I wouldn't be too worried about long term side effects. I would do everything I could to make sure the dog is as comfortable as possible. Plus tramadol is quite safe and doesn't cause long term problems.

 

We know that osteo is a painful process, and by the time a dog is "in obvious pain," it is severe. Especially in a case where pain is always present to some degree, preemptive pain management is much more effective. In other words, pain meds work better if you give them preventatively, before pain gets real bad, rather than wait for the pain to get bad and then try to get it back under control. The effects of tramadol only last 6-8 hours, so it doesn't make sense to only give it every other day.

 

I'm glad you're considering other pain management options too. Most dogs benefit from multi-modal therapy. Best wishes for your girl, and I hope you have a lot more quality time together.

[BauersMom]

Hi, initially we were given the tramadol to give to her ONLY when she was in obvious pain. Then I made an appointment with the vet last Friday where I discussed that I felt she may need more medication (it seems every dog on this thread is on more, and more regular doses than her) and the vet recommended keeping up metacam once a day, one dose of paracetamol a day and a tramadol every second day. she was of the view that the less she can get away with, the better. We've given the tramadol as needed though. I'm really unsure as to whether she should be on a regular dosage or not.

Why does your vet feel that "the less she can get away with, the better" regarding pain meds? Hate to be blunt, but when treating a terminal disease with palliative care, I wouldn't be too worried about long term side effects. I would do everything I could to make sure the dog is as comfortable as possible. Plus tramadol is quite safe and doesn't cause long term problems.

 

 

 

I agree - I wouldn't be holding back pain meds in an osteo case. I think moving up the frequency of tramadol should help quite a bit.

 

Berkeley had a "good" vet appt today! We pulled in, got out of the car and he ran right into the office! Of course, it was pouring and maybe that had something to do with it. But he wasn't freaked out and even the vet tech commented on how well he was doing compared to other weeks. And his white cell count is back in the normal range. YAY!

 

Today marks 7 weeks post-amp!

[NeylasMom]

Hi, initially we were given the tramadol to give to her ONLY when she was in obvious pain. Then I made an appointment with the vet last Friday where I discussed that I felt she may need more medication (it seems every dog on this thread is on more, and more regular doses than her) and the vet recommended keeping up metacam once a day, one dose of paracetamol a day and a tramadol every second day. she was of the view that the less she can get away with, the better. We've given the tramadol as needed though. I'm really unsure as to whether she should be on a regular dosage or not.

Why does your vet feel that "the less she can get away with, the better" regarding pain meds? Hate to be blunt, but when treating a terminal disease with palliative care, I wouldn't be too worried about long term side effects. I would do everything I could to make sure the dog is as comfortable as possible. Plus tramadol is quite safe and doesn't cause long term problems.

 

We know that osteo is a painful process, and by the time a dog is "in obvious pain," it is severe. Especially in a case where pain is always present to some degree, preemptive pain management is much more effective. In other words, pain meds work better if you give them preventatively, before pain gets real bad, rather than wait for the pain to get bad and then try to get it back under control. The effects of tramadol only last 6-8 hours, so it doesn't make sense to only give it every other day.

 

I'm glad you're considering other pain management options too. Most dogs benefit from multi-modal therapy. Best wishes for your girl, and I hope you have a lot more quality time together.

 

We did find that often when pain increased, we need to give a little "bump" to get ahead of the pain and then could maintain with a lower dose, but everything was always given on regular intervals to maintain an even level in her body.

 

Also important to realize that Tramadol is an opiate-like drug, which according to my onco vet means that if you increase it, you can't then just stop it or it could actually produce pain. Now I would assume the latter is only true if you're giving higher doses. If you're only giving 50 mg here and there as needed this probably doesn't apply to you.

 

Berkeley!!! And I'm sure the rain had nothing to do with him running into the vet's office.

[greysmom]

BERKELEY!!!!!!!!!!!!!!!!!!!!

 

That's awesome!

[Guest carla7]

Carla - good to hear that the appt went well. We use Angell also, and they've all been wonderful there.

 

How long do they want you to go without an NSAID and just tramadol? Can you add gabapentin in the interim while you switch to piroxicam?

 

Hi:

 

They told us to just go for today w/out the rimadyl then start piroxicam tomorrow am. Although I did think that you were supposed to wait at least a week due to increase in possible gi bleeding issues??? Persephone has been fine w/just the tramadol so far which is good.........now I am wondering if I should try to go a few more days w/out a NSAID and just tramadol??! While they did mention gabapentin as another potential med, they didn't suggest using it in the interim.

Carla

 

Piroxicam is part of the OSU (post chemo) metronomic protocol for osteo treatment. It has been shown to have some tumor fighting properties. You should also ask about adding in the chinese herb Artemisinin, for the same reason.

 

Hugs for everyone!

 

Hi:

 

I have actually been using Artemisinin since a few days after dx. Do you know how soon I should stop that if she is going to have radiation tx?? I forgot to mention to the vet that she is getting 300mg of that every night. I'll email him tomorrow. Hopefully it is helping with something, and maybe in combination w/piroxicam, the tumor won't grow as rapidly.......

thanks,

Carla

 

BTw, thanks everyone for your compliments on my beautiful girl.

 

Just wondering if anyone has had any success/pain relief/stress relief/anything positive for their dog from alternative therapies like reiki etc?

 

Hi Suzanne:

 

I don't know how effective it would actually be as I don't personally know anyone who has tried it but acupuncture was suggested to me by the vet. He said that many people found their dogs responded well and it did help w/pain relief.

Carla

 

Hi, initially we were given the tramadol to give to her ONLY when she was in obvious pain. Then I made an appointment with the vet last Friday where I discussed that I felt she may need more medication (it seems every dog on this thread is on more, and more regular doses than her) and the vet recommended keeping up metacam once a day, one dose of paracetamol a day and a tramadol every second day. she was of the view that the less she can get away with, the better. We've given the tramadol as needed though. I'm really unsure as to whether she should be on a regular dosage or not.

Why does your vet feel that "the less she can get away with, the better" regarding pain meds? Hate to be blunt, but when treating a terminal disease with palliative care, I wouldn't be too worried about long term side effects. I would do everything I could to make sure the dog is as comfortable as possible. Plus tramadol is quite safe and doesn't cause long term problems.

 

 

 

I agree - I wouldn't be holding back pain meds in an osteo case. I think moving up the frequency of tramadol should help quite a bit.

 

Berkeley had a "good" vet appt today! We pulled in, got out of the car and he ran right into the office! Of course, it was pouring and maybe that had something to do with it. But he wasn't freaked out and even the vet tech commented on how well he was doing compared to other weeks. And his white cell count is back in the normal range. YAY!

 

Today marks 7 weeks post-amp!

 

 

Very happy to hear that Berkeley is doing so well!!

[TwiggysMom]

I'm so sad to see how many hounds have been newly diagnosed in the past couple weeks or so. I hope all are comfortable and doing well today.

 

Great to hear about Berkeley's calm vet appointment! Hopefully, he is starting a new trend!

 

Twiggy's infection seems to have cleared - her new incision looks calm and dry, and the stitches are due to come out on Tuesday, so chemo could start next week. She has started fluffing her beds again, not a small feat when you only have 1 front leg . I also got her to snuggle with me for the first time ever last night. I've been sleeping on an air mattress on the floor since we've been back home, and I coaxed her up onto it, and she did lay down next to me for maybe 10 minutes or so. It was so nice. She's never been a snuggler, and she firmly believes that dogs don't belong on human furniture.

 

We met with an oncologist (board certified, and well regarded) yesterday, and I really liked her, but this whole practice seems to have something against OSU. They keep making sort of snide comments about them i.e. - asking why on earth did I go to OSU to have Twiggy's surgery, and how does Couto get all the greyhounds?... The onco says she probably doesn't want to use the free chemo drugs OSU provides because she doesn't trust them to do it right. . Seriously?? She'll be happy to sell me the same chemo drugs, though. Aside from that, I like her very much, so I may take Twiggy there even if I have to buy the doxo or carbo from them.