Osteo Thread Part V I I

[krissn333]

Do not feel sad or guilty. Yes, healing from an amputation is rough, but, you will be amazed at how different Ralph will be feeling in just a few days.

 

Standard pain management for greyhounds following amputation is a fentanyl patch - make sure he's got one of those.

 

Is he on Amicar? If not, get him on it right away. It will make a HUGE difference in the amount of bleeding and bruising/pooling he will experience as he heals.

Basic oral drugs:

 

Deramaxx or Rimadyl - this is an NSAID, like you or I would take Aleve or Advil for pain. I MUCH prefer Deramaxx to Rimadyl, I have just had better luck with it overall in my dogs. Post-surgical dosing can be higher or more frequent than what you'd normally give for pain. Deramaxx in general is dosed once every 24 hours but can be dosed every 12 for post-op pain.

 

Tramadol is a standard oral medication that is given for pain - however, be aware that in SOME greyhounds, it can cause anxiety, panting, and weird behavior. Some dogs do better with smaller doses closer together, for example, 100mg every 6 hours or 8 hours vs giving 200 mg every 12 hours.

 

Gabapentin is an excellent medication to use - it does take a few doses to really start working in the system. Greyhounds metabolize gabapentin more quickly than other breeds of dog, so, it should be given every 8 hours.

 

Most greyhounds stay in the hospital for a few days following surgery. However, some do not do well there - they are agitated by the hustle and bustle and being kenneled. Work with your veterinarian to determine what will work best for Ralph. My Pinky came home just 24 hours after she woke up from surgery - she was extremely agitated that she couldn't get up and walk around and she did not like being in the kennel. She also didn't like being "ignored" (she just wanted someone to sit and pet her all day and those poor people at the hospital just cannot do that), so she would sit there and whine/make noise until someone paid attention to her

 

Take a deep breath. Yes, you're going to have a tough next week or so - but you will be AMAZED at how quickly they adapt.

 

Hugs

[Tallgreydogmom]

The first amputation is the toughest. We just amputated for the 7th time. We are long time greyhounds lovers. We have never looked back on the decision.

 

Please take advantage of the free chemo offered by Ohio State University. Email the ladies at the blood bank and they will get the process going. Someone from your vet's office will also have to contact them.

 

Amanda.Simons@cvm.osu.edu>

iazbik.1@osu.edu

 

You can give them a call also.

 

Cristina Iazbik, DVM
Managing Director
Animal Blood Bank
Phone: (614) 688-8460

Edited November 3, 2013 by Tallgreydogmom

[Victor]

Sarah, this is definitely the right place to talk about Ralph. We also had difficulty getting Lana's pain under control after her back leg was amputated in July. I agree with Kristin that a mix of pain meds seems to work best. I highly recommend including gabapentin in the mix; in addition to relieving pain it'll help reduce the likelihood of phantom pain. In addition to the NSAIDs Kristin mentioned there's also Previcox and Piroxicam, if Ralph doesn't tolerate Rimadyl or Deramaxx.

 

It also took Lana some time to get her appetite back. Some things that worked for Lana are baby food (chicken and turkey), vanilla Ensure, and baked skinless chicken breast. We didn't know about this for Lana, but Hills now has a canned food that's formulated for dogs undergoing chemotherapy called Hill's n/d: http://www.hillspet.com/products/pd-canine-nd-canine-canned.html . You could ask your vet about getting a prescription for that.

 

These next few days are going to be tough, but it will get better. Hang in there!

[Charlies_Dad]

I am having a REALLY tough time right now. October and November are full of dates I almost wish weren't tattooed on my brain.

 

October 5th would have been Fritz's 9th Gotcha Day

 

October 12th marked three years since I said goodbye to Sutra

 

October 13th marked one year since we learned Pinky had lung mets.

 

October 22nd marked two years since Pinky was diagnosed with osteo.

 

November 7th marks two years since she had her amp.

 

November 19th marks one year since we had to say goodbye

 

I am flooded with all of the emotions from all of the losses I've had over the last year. It's just SO damn hard.

 

Far too many sad memories Kristin.

 

I'm sorry that Python's mets have progressed. I hope the new protocol will help give you more time.

 

Sending good thoughts for Lana too. I know Palladia can give them stomach upset. When Charlie was on it, we gave him metronidazole daily.

 

For Ralph's mum, please don't feel guilty. You made a decision to help him and that is what you have done. The initial days after amputation are tough and getting the pain under control with the right meds is critical. As Kristin stated a Fentanyl patch is standard for pain management and some meds, e.g. Tramadol, can sometimes cause some pups to be restless. Good thoughts for your boy and you will be surprised how quickly he will bounce back!

[Guest Sarah2013]

thank you all for replying and reassuring me about Ralph.

As he's still in intensive care, he hasn't been receiving any oral medication, it's all injectable (or in his infusion) and has included fentanyl.

I'm not sure if aminocaproic acid (amicar) is available in australia - it might be from a compounding pharmacy, but i'll have to look into that.

I have this unquantifiable feeling that he can get through this - once he's home, I think he'll be ok, because I can help him learn how to get around again. He just needs to get through this period at the vets. I know he doesn't like being at the vets, but i don't think he can come home until he's eating a little so I'll be able to give him pain relief. I'll take in some yummy food today and see if he's interested. I believe the vets are doing everything possible for him - they've been attending to him round the clock. I just need to be patient and know that if he's strong enough to make it through the surgery, then he can get through this.

 

Thanks again for chatting - it is helpful to hear from people that have had similar experiences and know that their greys are better off for having had surgery, after the initial recovery period.

[Guest Sarah2013]

i just had some positive news from the vets - ralphy stood up and turned himself around in the cage overnight, which they were all really surprised about! in doing so he pulled out his catheter, so he hasn't had his pain meds for a while but he was fairly comfortable without them for a period, so that's good! he's been outside (with help!) and is weight bearing on the other three legs - just getting his balance and coordination right now! They'll give him pain meds when he needs it, obviously, but he was on really high doses of many drugs that had him pretty spaced out i think, so it'll be good if he can do without the constant rate infusion - then he can come home soon! (hopefully).

Maybe he's out of the woods now

I'm so relieved!

[krissn333]

Pinky was a rear leg amputation, but, many people here that have had dogs with front leg amputations have used an assistance harness for the transition period until their new way of balancing becomes second nature. Hopefully someone will chime in with the best one...I can picture it in my head but can't for the life of me think of the name of it.

[TwiggysMom]

Victor, I'm sorry to hear that Lana has been reacting to the Palladia. I hope the metro helps, but it may be that she won't be able to tolerate it long-term.

 

I am also sorry to hear that Python's mets are increasing in size and number, definitely not the news any of us wanted to hear.

 

Kritsin, you've been on my mind this weekend - I didn't even realize that so many significant dates happened over these recent/coming weeks. I hope I get to see you next weekend, and meet Ozzie!

 

Cora, I hope everything is going well!

 

Sarah2013 - I'm just catching up now, and am glad to hear that Ralphy is turning a corner! My girl is also a front-left let amputee. When he gets to come home, you'll want to have an area set up for him to recover where he won't have to negotiate much physically - not only will he be painful for a while, you don't want him accidentally pulling out any stitches/staples.

 

It is helpful to make a chart or set up a bunch of alarms on your phone for his med schedule. There will be a lot of meds, and it will be difficult to keep track of which have to be given when and with what (food or no food, etc.). You probably won't get much sleep for the first few nights, at least, and if you can take time off of work to help him recover (or have someone who could spend time with him), that would be helpful.

 

The recovery is difficult, so don't let his initial condition get you down. He won't seem entirely like himself for a few weeks, and then you'll start seeing bits of his normal self coming back. After about 4-6 weeks, Ralph will start seeming much more like his old self, and by 2 months, he should be back to all his old habits!

 

Whatever you do, please don't doubt yourself! All any of us can do is make the best decisions we can based on the knowledge we have. Please continue to let us know how Ralphy is doing!

[krissn333]

Thanks Wendy.

 

Yep, we will be at the GO RAVE next weekend...we are looking forward to it and I'm hoping for nice weather so Ozzie can do the fun run

 

My mom is coming too - she has been hearing about Twiggy for so long I'm excited for her to finally meet her

[Guest bozicj]

thank you all for replying and reassuring me about Ralph.

As he's still in intensive care, he hasn't been receiving any oral medication, it's all injectable (or in his infusion) and has included fentanyl.

I'm not sure if aminocaproic acid (amicar) is available in australia - it might be from a compounding pharmacy, but i'll have to look into that.

I have this unquantifiable feeling that he can get through this - once he's home, I think he'll be ok, because I can help him learn how to get around again. He just needs to get through this period at the vets. I know he doesn't like being at the vets, but i don't think he can come home until he's eating a little so I'll be able to give him pain relief. I'll take in some yummy food today and see if he's interested. I believe the vets are doing everything possible for him - they've been attending to him round the clock. I just need to be patient and know that if he's strong enough to make it through the surgery, then he can get through this.

 

Thanks again for chatting - it is helpful to hear from people that have had similar experiences and know that their greys are better off for having had surgery, after the initial recovery period.

 

About the Amicar: We had it prescribed by the vet but got it through the human pharmacy so I don't know why it wouldn't be available in Australia. It's usually recommended to start it a 2-3 days before amputation and then continue for about a week after. It does make a HUGE difference for greyhounds so if you can get it in the mix, you totally should!

Urinalysis came back for Python last Thursday with protein, blood and bilirubin (sp?) in there so we had to delay starting her new chemo until we figure out that (since the Cytoxin can have some bladder/urinary side effects). So she's back at the U today for an abdominal ultrasound and sterile urine sample. Hopefully it'll just come back as something super treatable like a UTI instead of stones or stomach tumor.

 

As usual, she is acting totally normal/happy/cuddly/adorable. Focusing on the positive.

[Guest fastcasper]

To Ralph's mom, I read your posting and got a pit in my stomach because I felt the same way you do with my boy. He is a front leg amputation too and I did regret it for almost 5-6 weeks. He didn't seem to be coming along like everyone said he would, or what I read here. He was not in pain or lame when I had the procedure done, but it was a very short matter of time (I think) before he would be in pain. He had trouble adapting and just as he was getting better he got terrible phantom pains. He got amputated on July 1 and I am glad I did it because he JUST celebrated his 10 birthday yesterday and he is his normal happy self now. He still has phantom pain and probably will for his remaining life, but it is 95% under control (gabapentin is great!) If I didn't do the procedure, I do think he would not be here now, and that was not an option. Hang in there! Ralph has had a major surgery and he is doing great!!! Get him home, keep him calm and be on a pain management schedule. You will have to set your alarm for 2,3 or 4 a.m. to pill him, but you need to and it WILL pay off soon!!

 

I keep thinking of Lana and Python! Hang in there girls!!!

 

I heard back from Dr. Mason at Upenn about the vaccine study/trial, but Casper does not qualify because he has had 6 round of carboplatin chemo and the criteria is amputation and 4 rounds of carbo chemo. Dr. Mason hopes to expand the criteria in the next few months, but I'm not sure if Casper will participate then. He has his "re-staging" in two weeks and I'm already getting nervous about it.

[Guest Sarah2013]

Hello all. I enquired about aminocaproic acid and the vets told me there's an alternative product that has shown greater efficacy (i can't remember the name now) that they have been giving ralph. Ralph's pain seems to be under control now, which is great. However there is an area of the wound that has become necrotic, and now he has to go back to surgery to get the wound debrided. The vets don't think there's enough skin to suture it again, so it will have to be an open wound and heal by secondary intention. Additionally, after the necrotic area has been removed, other parts of the wound may become necrotic in a couple of days time - in which case i need to decide to send him back to surgery (or not). He's not very well or happy today. Yesterday I was so hopeful and optimistic because he wanted to get up and move around, but today he is lying flat on his side again, not interested in trying to get up or move. The vets think that some toxins from the necrosis have got into his bloodstream and are making him feel unwell. He's going back to surgery this afternoon, but i don't know how much more i should put him through. I think i'm doing this for him, so he can have a chance to be happy again, but maybe it's for me, because i don't want to say goodbye? i'm not exactly in an objective position...

the vets think that he has given up

 

thank you all for responding to me and i'm sorry i haven't commented on your situations directly, but i have read them, and I hope that caspar, python, twiggy and lana (and anyone else i have missed) are all managing to live life to the fullest with their devoted owners

[Victor]

Sarah2013, from what I understand it's not unusual for there to be necrosis at some point after amputation. It's unfortunate that Ralph has to undergo surgery again so soon, but the debriding may help him feel better if toxins are being released into his bloodstream. An open wound is also not that uncommon. Others on this forum can offer greater insight than I, but I wouldn't give up hope just yet. See how he does after the debriding. My thoughts are with you and Ralph.

[Guest Sarah2013]

hello again. unfortunately i had to say goodbye to ralphy this afternoon. They put him under anaesthetic to debride the wound and investigate the health of the underlying tissue, and there was a lot of infection and necrosis spreading all throughout previously health muscle and into his other front leg. They didn't think that he could recover from that, and so I decided to let him go.

 

thanks for all your support - it's very helpful to have a forum like this available for the tough times.

 

good luck to all of you and your hounds

 

Sarah

x

[Guest fastcasper]

I AM SO SORRY SARAH FOR YOUR LOSS. You did everything to help Ralph but a fast spreading infection is very nasty to deal with. Given the situation, you did make the right choice at that time. You are a brave soul and I commend you for that. Pease take care of yourself!

[Victor]

I'm so sorry, Sarah. My heart goes out to you.

[dante2zoe]

Sarah, I am just so very sorry.

[greysmom]

I'm so sorry for your loss of Ralphie. {{{{{hugs}}}}}

[45MPHK9]

I'm very sorry for your loss, Sarah.

[krissn333]

I am so, so very sorry Sarah

[Guest bozicj]

Python update: We had an ultrasound this week to see what was up with the urine sample that had protein, blood and bilirubin in it last week. There's some sort of mass in her bladder but we're not sure if it's malignant or just some hardening of the lining of the bladder or something else. It doesn't appear to be causing any other issues so we're not biopsying it now. We're just going to choose a chemo that isn't as likely to cause more bladder issues.

 

So, cytotoxin is getting skipped. We're going on to Chlorambucil/Leukeran instead. Hopefully that will stabilize her.

 

Poor girl had her fur all back finally after her amp and now they shaved her sides for the ultrasound. Just can't win with the fur.

[greysmom]

Bumping for new members

[TwiggysMom]

Sarah, I am truly sorry that you had to let Ralphy go. Osteo doesn't seem to play nice anymore. It breaks my heart that so many dogs like your lovely boy are being taken by it so quickly.

 

 

I hope Python's bladder issue remains asymptomatic, and that the new combo of meds keeps everything at status quo!

[Charlies_Dad]

Sarah, truly very sorry for the loss of your sweet boy. This disease is so unfair and cruel in so many ways.

[Guest fastcasper]

Casper update. His last CBC came back looking good. The vet is pleased. I am already getting stressed about his next appt. with the oncologist. It will be his "re-staging" appt. Urine, blood and chest x-rays. He goes in on Nov. 19th (one week). Trying to stay positive. I started him on his Art 10 days after his last chemo treatment. He takes it at night, but I am not giving him any other supplements. I went on the Yahoo group for Art and they have SOOOO much information, that I find it all very over whelming. Plus I am not doing a holistic treatment with Casper. So I don't know what else I should add. Does anyone have any suggestions? I am trying to keep it fairly simple for Casper has he is a very picky eater and KNOWS what should be in his bowl and what should not be. Does anyone use Curcumin? Is that something I should add? Any advice would be appreciated!

 

Kim and Casper