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Whining & Panting After Dental - Need Advice!


Guest Racheal

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Guest Racheal

I am new to this forum & in desperate need of help. I apologize in advance, this post is very long but detailed. PLEASE read on to try to help us!

 

Background: My 10 year old greyhound, Pegasus, had 9 teeth extracted during her dental visit this past Wednesday (4 days ago). She was given a shot of Buprenorphine for extended pain relief (lasts ~ 3 days). Pegasus also has Tramadol & Rimadyl at home from a recent ACL injury 2.5 weeks ago.

 

Symptoms: Since returning from the dental, Pegasus has suffered from SEVERE nonstop anxiety. She is panting & whining constantly & is suddenly nervous around us with an exaggerated startle reflex. Typically, she is a very quiet dog & up until now, has never whined or barked EVER. Her ears are up & facing forward like on high alert & her eyes look like they are bugging out of her head & look "crazed". According to the vet, she was not showing these symptoms while there (just the typical panting).

 

In addition, Pegasus refuses to eat & has only eaten a few bites of food last night. We have tried numerous things to tempt her to eat: wet dog food (3 kinds); soft foods like mash potatoes, cheese, peanut butter on bread; beef broth and tiny pieces of chicken & hamburger. We have tried the food cold & warm. She barely sniffs the food. Pegasus IS drinking water & can get up to urinate (although very shaky).

 

Things we have ruled out: Tramadol & Rimadyl - she was on the meds before her dental with no issues.

 

Anesthesia - the vet has experience with greyhounds & used proper anesthesia. In addition, it would be out of her system by now. According to the vet, her dental was routine & uneventful.

 

Pain - we believe the Buprenorphine is still working because she is walking on her injured leg & hasn't taken the Tram/Rim for 4 days. Prior to the Buprenorphine & without the Tram/Rim she could not put any weight on the injured leg.

 

Other - she does not have a fever. We managed to sneak 2 antibiotics into the few bites of hamburger she ate yesterday but obviously needs to take the rest of them. Her mouth is not bleeding, drooling has reduced and her gums are pink. She does not appear to be dehydrated.

 

Things we have tried to help: I called the vet twice & she agreed it sounded like an anxiety attack (but the attack has lasted for 4 days, day & night, very little sleep for any of us). The vet prescribed acepromazine to take the edge off & it totally knocked her out for 2 hours but when she woke up she immediately started whining & panting. We gave her half the original dose this morning but again, only helped for a couple of hours. Pegasus is laying in her usual area with fluffy bedding. We are keeping the room dim & trying to keep the house as quiet as possible (as much as we can with children aged 5 & 3!). Note: Pegasus acted the same with just me home as well as with the kids & hubby home.

 

Thoughts: Possible "psychotic" reaction to Buprenorphine since it lasts 3 days & she wasn't whining at the vets & left right after the Bup shot (so they wouldn't have observed her with the pain shot in her). Or, my poor baby has had some kind of mental "break" from the stress of spending the day in a crate at the vets (she hasn't been crated since we adopted her 7 years ago). Or, she IS in incredible pain & she is walking on her leg, despite her injury. Or?????

 

I apologize for writing a novel but I wanted everyone to know EXACTLY what is going on. We are very worried about her mental state (anxiety, fear & mistrust of family, startling easily), lack of eating and inability to give her the medication. Any thoughts, advice or personal stories about dentals or sudden severe anxiety would be greatly appreciated! Thanks, Racheal & Pegasus

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Wish I could help......but just sending all the good thoughts I have for you.

 

I would be suspect of pain somewhere though......Her lack of willingness to eat might be indicitive of some painful situation in the mouth. Could she have an exposed root? Or could a tooth have fractured when they removed it causing her to possibly have an infection which might not result in a fever yet, but might cause pain?

 

I would stay in close touch with my vet....and, as you have been, monitor her water intake very closely.

 

Best wishes....I am sure others will have more advice...hang in there!

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Robin, EZ (Tribal Track), JJ (What a Story), Dustin (E's Full House) and our beautiful Jack (Mana Black Jack) and Lily (Chip's Little Miss Lily) both at the Bridge
The WFUBCC honors our beautiful friends at the bridge. Godspeed sweet angels.

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First of all Buprenex does NOT last 3 days it's more like 8 hours. You mentioned you stopped the Rimadyl and Tramadol?

I would absolutely get your hound back on the rimadyl-she sounds like she's in pain. I would see if that helps first before reintroducing the Tramadol as that can make them act anxious.

Edited to add--thinking to think of what your vet gave your pup to last 3 days and that it would make her act so--does she have a patch on her?

 

Edited again-did your vet use the BuprenophineSR? That would explain things---that does last 72 hours--should almost be depleted soon. Note in her chart--no more opiates!

Edited by tbhounds
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Guest Racheal

Of course we would have a health crisis on a holiday weekend when our Vet is closed - ugh! I'm not sure about the exposed nerve/cracked tooth but I will have my Vet check when she returns on Tuesday.

 

As for stopping the Tramadol & Rimadyl - I wish that was our decision to stop. We have been trying to give her the meds for the last 4 days but we are too nervous to put it down her throat so we mash it up & put it in her food. But she is refusing to eat, so no meds :(

 

Any ideas on how to get the Rimadyl & antibiotics into her without stressing her out more? The antibiotics are just capsules so we could sprinkle it in food if she would eat it. The Rimadyl are huge "chewable" pills that she refused to eat even before her dental. We used to hide it in cheese - when she was eating. I can't think of any other food choices to tempt her that we haven't tried already. Any ideas??

 

Finally, I do believe the Buprenorphine was sustained release...but I will confirm on Tuesday.

 

Please keep the ideas and recommendations coming - we are at our wits end & can't stand the thought of her suffering :(

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As soon as the opiate wears off I'm sure she'll find her appetite back. Have you tried meat baby food? It's really palatable.

My guess is she's not hurting--just a bad trip from the opiate--many many hounds don't do well with them. Remember big note in her chart--no more opiates.

I bet she'll be acting better by tomorrow--might be a long night for ya :-(

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I am so very sorry you are going through this. We have had the exact same issues with our dog Seamus and Buprenorphine. After an leg injury, the vet gave him an injection for pain relief, and it was horrible. He was glassy-eyed, agitated. and panting for over 24 hours. He wouldn't stop whining and wouldn't sleep. After a horrible night, I took him back to the vet, and they gave him a fentanyl patch--which was even worse. I won't go into the details but it was really awful. We were also given acepromazine to calm the anxiety, and it just added fuel to the fire. Not only was he agitated and unhappy, but he couldn't even stand up, walk, or go outside to relieve himself.

 

I am not a vet, but I am guessing that Pegasus is very sensitive to pain meds and that would include Buprenorphine. Seamus is super sensitive to any and all pain meds. They send him into a weird, disphoric state where he pants and whines and cannot be consoled. He also won't eat anything, so I understand about the difficulty getting the other meds into her. Just keep trying different foods--cream cheese? Some kind of meat? Our experience was that you just have to wait for it to wear off. If it gets really bad then you might be looking for an E-vet to take her to, but we just stayed with Seamus until it wore off. Again, I am so sorry that you are going through this. It really is tough to watch them--the experience we had with it was one of the worst we have ever gone through with our guy.

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And a warning about acepromazine: it doesn't reduce anxiety in dogs. It just reduces their ability to express the anxiety without falling on their faces. (Reportedly, it does the same thing to people taking it, which is how the experts found out about its actions in dogs.)

 

In other words, it'll make Pegasus stop whining, but not make her feel better. Lots of vets still use it because it undeniably has an effect on dogs. But there are other drugs that work better. It didn't do her any harm, but you want to keep its limitations in mind for future events.

 

Keep Pegasus hydrated. In fact, the more she drinks the sooner this might clear up since she'll be feeling the effects of the buprenorphine until the drugs clear her system--which'll happen through her kidneys.

 

Also: no aged cheese (if you're trying to get her to eat, you might think to try that--but don't). And if it's time for flea meds, wait--don't use them until the buprenorphine is out of her system. Aged cheese or flea meds: these both showed up as no-nos in at least one website I found tonight.

Edited by KF_in_Georgia

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Kathy and Q (CRT Qadeer from Fuzzy's Cannon and CRT Bonnie) and
Jane (WW's Aunt Jane from Trent Lee and Aunt M); photos to come.

Missing Silver (5.19.2005-10.27.2016), Tigger (4.5.2007-3.18.2016),
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How is your baby today?

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Robin, EZ (Tribal Track), JJ (What a Story), Dustin (E's Full House) and our beautiful Jack (Mana Black Jack) and Lily (Chip's Little Miss Lily) both at the Bridge
The WFUBCC honors our beautiful friends at the bridge. Godspeed sweet angels.

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Thoughts: Possible "psychotic" reaction to Buprenorphine since it lasts 3 days & she wasn't whining at the vets & left right after the Bup shot (so they wouldn't have observed her with the pain shot in her). Or, my poor baby has had some kind of mental "break" from the stress of spending the day in a crate at the vets (she hasn't been crated since we adopted her 7 years ago). Or, she IS in incredible pain & she is walking on her leg, despite her injury. Or?????

 

 

We had almost exactly the same thing happen with Sid after a recent dental. He only had two of the smaller molars out (but right at the back) plus one tiny incisor, but he whined ALL NIGHT when he came home, looked uncoordinated and anxious, and if anything, his anxiety increased over the next few days, not helped by the fact that he panted so hard and refused food and drink so long during a hot spell that he ended up back at the hospital getting rehydrated where .. guess what? They kept him on more opiates. They did NOT suit him. He looked terrified, ran away from us as if he didn't recognise us and looked just wrong.

 

The young, newly qualified vet who had been looking after him in hospital and who had NOT listened to me when I told her he was not usually an anxious type of dog told me he'd probably had a stroke under the GA. I was devastated. However, the more I thought about it, the more convinced I was that his paranoia/psychosis was the fault of the Vetergesic he'd been on. It took the best part of three days to really clear his system and for him to begin to recover his personality. We then put him on Tramadol and he was fine with that.

 

It was complicated by the fact that they injected him with Ceporex subcutaneously and he had a nasty reaction to that. It was several weeks ago and he still has a gradually healing wound on his neck from that. I was livid by the way the whole thing was managed, but we do have our sweet old Sid back, which is the main thing.

 

 

First of all Buprenex does NOT last 3 days it's more like 8 hours.

 

Edited again-did your vet use the BuprenophineSR? That would explain things---that does last 72 hours--should almost be depleted soon. Note in her chart--no more opiates!

 

I think that is what they used on Sid, and it's my thinking too. That would do it for sure. They now have Sid down as 'no more opiates'.

 

The good news is that if it is a drug intolerance/reaction, she should be back to her old self given time. How long it will take will depend a bit on her, I think. Sometimes these paranoid reactions can shake them up a bit.

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Guest Racheal

Thanks for all of the helpful ideas and support! I am so happy to have found such a wonderful group of people :)

 

We stopped the acepromazine after KF_in_Georgia's helpful advice and article link. I swore that Pegasus was still awake after we gave the sedative to her. She still looked distressed, but paralyzed on top of it. Glad to know my intuitions have been correct so far. We will never use that drug again!

 

We didn't have any luck getting Pegasus to eat last night however, she DID eat a little bit this afternoon. I was able to sneak some Rimadyl into a cup of mashed potatoes with beef broth. She probably ate 3/4 of the pill before she noticed them in the potates & stopped eating. We are going to buy some meat babyfood per tbhounds suggestion. Yuck! I didn't even feed my own kids meat babyfood! LOL :) We still need to get her antibiotics in her before she gets an infection!

 

Pegasus is drinking a little more water and is resting more frequently. Her whining HAS decreased but is still there. I firmly believe that the Buprenorphine was to blame after hearing from all of you about greyhounds and opiates. The stories about Seamus and Sid from Shaysmom & silverfish confirmed my suspicions about the Bup. I feel better knowing that it will eventually pass. I can tell the Bup is wearing off because Pegasus is starting to limp again on her injured foot. Hopefully the Rimadyl will help with that - we now need to give her a bath because she had an accident on her blanket :( My poor darling, she has gone through so much over the last two weeks!

 

I will check in with everyone tomorrow and let you all know how she is doing. Please keep the ideas coming for foods to try to entice her to eat. Yesterday I went to the grocery store and bought her a cooked rotisserie chicken and waved the open bag in front of her face..........nothing, not even a lick.

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Sid ate very little while he was feeling like this. Best success was with warm chicken stew (made specially for the dogs from chicken carcases complete with giblets and with all the bones cooked till soft and ground up). He also ate sardines in tomato sauce. Oh, and he drank milk with a splash of boiling water in it just to take the chill off.

 

Have you tried grated parmesan cheese? The dried stuff you buy in tubs is fine, and a little shaken over the food can work wonders. Garlic can work, too. If you can get garlic flavoured oil, just a half a teaspoon in the dinner can get them interested.

 

Cheese balls work well for pills in this house. Just push the tablet into a bit of grated cheddar cheese and mould it around the pill. They don't usually bother to chew, so don't really notice what's inside.

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Also: no aged cheese (if you're trying to get her to eat, you might think to try that--but don't). And if it's time for flea meds, wait--don't use them until the buprenorphine is out of her system. Aged cheese or flea meds: these both showed up as no-nos in at least one website I found tonight.

 

I've never heard advice to keep away from aged cheese with buprenorphine. I think there may be some confusion because you can't take buprenorphine with MAO inhibitors, and you can't eat aged cheese or fermented food products etc when you're taking MAO inhibitors. However, I'm not an expert, and I'm not going to advise you to ignore this, so strike the suggestion of parmesan until you get a chance to check with a vet. JMHO.

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Guest alannamac

Poor thing. Yes 9 teeth must be very parinful.....some of them far more painful than others....if one is a canine tooth that's a particularly awful spot......Ace is awful stuff and does cause the "trots" or "runs" as some people call them.....it sedates the dog to make them more compliant to others, but is not necessarily good for the dog.......I'm wondering with all of the meds you speak of if it's not better to take her off all but the antibiotics and tramadol slowly reintroducing rimadyl after several days and weaning off of the tramadol......not a vet here....just a mom who had a pup go through similar things (not so many meds at once though)

Also, as one who went through a bad experience with Rimadyl (my pup vomited blood and had a terrible reaction)......please be careful and watch for signs of stomach upset....always give with a BIG meal. If your pup isn't eating, rimadyl can be really hard on the stomach.

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Apparently, the combination of aged cheese (or MAO inhibitors) with buprenorphine can cause a dangerous rise in body temp and blood pressure. See here (link to a PDF from the Veterinary Drug Handbook), here, and here.

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Kathy and Q (CRT Qadeer from Fuzzy's Cannon and CRT Bonnie) and
Jane (WW's Aunt Jane from Trent Lee and Aunt M); photos to come.

Missing Silver (5.19.2005-10.27.2016), Tigger (4.5.2007-3.18.2016),
darling Sam (5.10.2000-8.8.2013), Jacey-Kasey (5.19.2003-8.22.2011), and Oreo (1997-3.30.2006)

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Apparently, the combination of aged cheese (or MAO inhibitors) with buprenorphine can cause a dangerous rise in body temp and blood pressure. See here (link to a PDF from the Veterinary Drug Handbook), here, and here.

 

I've seen 'The Compounder', which seems to be a site run by pharmacists, and the way it's written there made me wonder if there was a error. One of the other links only mentions MAO inhibitors (whose interaction with aged cheese is well-established), and I can't see where the other one is coming from, but it's worded so similarly to the Compounder's info that I wonder whether one was taken from the other. Sorry if I sound nit-picking here, but it's honestly something I've never, ever heard of before, and my own vets have never given me any warnings. I personally can't find anything trustworthy on the internet about it. All of the reputable links I've found - for people or animals - have only mentioned the MAO inhibitors, and in the case of the animals, the flea/tick collars.

 

We all know how misleading the internet can be at times. You're probably right, but I'd like to find two or three trustworthy and up-to-date links - or hear from one of GT's vets - before I pass that info on for myself. :)

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The plural of anecdote is not data

Brambleberry Greyhounds My Etsy Shop

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Apparently, the combination of aged cheese (or MAO inhibitors) with buprenorphine can cause a dangerous rise in body temp and blood pressure. See here (link to a PDF from the Veterinary Drug Handbook), here, and here.

 

I've seen 'The Compounder', which seems to be a site run by pharmacists, and the way it's written there made me wonder if there was a error. One of the other links only mentions MAO inhibitors (whose interaction with aged cheese is well-established), and I can't see where the other one is coming from, but it's worded so similarly to the Compounder's info that I wonder whether one was taken from the other. Sorry if I sound nit-picking here, but it's honestly something I've never, ever heard of before, and my own vets have never given me any warnings. I personally can't find anything trustworthy on the internet about it. All of the reputable links I've found - for people or animals - have only mentioned the MAO inhibitors, and in the case of the animals, the flea/tick collars.

 

We all know how misleading the internet can be at times. You're probably right, but I'd like to find two or three trustworthy and up-to-date links - or hear from one of GT's vets - before I pass that info on for myself. :)

 

If it were me I'd err on the side of caution and not give the idea to the OP that aged cheese is alright to give in this instance.

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Glad to hear that she is progressing!

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Robin, EZ (Tribal Track), JJ (What a Story), Dustin (E's Full House) and our beautiful Jack (Mana Black Jack) and Lily (Chip's Little Miss Lily) both at the Bridge
The WFUBCC honors our beautiful friends at the bridge. Godspeed sweet angels.

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Guest Racheal

Just when I thought Pegasus was improving....she has started to eat selective things but the panting, whining and agitation have returned with a vengeance all last night and today.

 

I gave her the antibiotic and Rimadyl with food (to protect the tummy) this morning. She has eaten a decent amount of food, still drinking water and going potty outside. She is not constipated or dehydrated. The Buprenorphine has definitely worn off as she has returned to severely limping on the torn ACL. I gave her a Tramadol a few hours ago (trying to observe her behavior while keeping the meds separate). Tramadol caused no behavioral changes, just helped her walk.

 

At least she is now eating but her anxiety is still through the roof and she seemed to be improving last night :( I have not & will not use the Acepromazine.....I will keep everyone posted.

 

PS - Vet is clueless, wants me to keep using the Ace for her "anxiety attack". As long as she is eating & doesn't have a fever, I'm going to avoid the vet's office for fear it will tip her over the edge.

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Oh dear .. poor girl.

 

First, are you absolutely sure it's not the Tramadol? This drug can cause aural hallucinations, as I know first hand (when I was on it, I was actually answering the voices I could hear, which worried DH somewhat!) and dogs can be really thrown by hearing noises they can't identify. I remember one GTer's dog going nuts at a perfectly empty wall, as if she could hear something behind it, and whining and pacing and general restlessness are common with Tramadol.

 

If you are sure it's not that, can you get a second opinion? Better to get her seen and treated than to avoid going because you don't want to see this vet. I know it's a worrying thing, wondering if it will tip her over the edge, but you probably need someone to take a look at her. Greytalk is a great resource, but can't work miracles. :(

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The plural of anecdote is not data

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Wish I had advice....just sending good thoughts.....

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Robin, EZ (Tribal Track), JJ (What a Story), Dustin (E's Full House) and our beautiful Jack (Mana Black Jack) and Lily (Chip's Little Miss Lily) both at the Bridge
The WFUBCC honors our beautiful friends at the bridge. Godspeed sweet angels.

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Why did the vets extract so many teeth? It must hurt like hell and I think it's normal, that the dog whines of the pain in his mouth.

I'm sorry that you have to go through this and I hope that pain meds do their trick soon...

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Perseverance is not a long race...

it is many short races one after another.

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