Limping, Have Xrays

[NeylasMom]

If she is in that much pain, can you speak with your vet over the phone about increasing dosages. I don't remember if you mentioned earlier what she's on right now, but the combination of Gabapentin, Tramadol and an NSAID (Rimadyl, Deramaxx, etc.) seem to work best at addressing the pain. You have a good bit of room to increase dosages on the first two medications. Remember that at this point you need to be concerned about addressing her immediate pain, not side effects from chronic use so the max allowable dosages are higher than they would be in other situations. Also worth keeping in mind that Gabapentin has a relatively short half life meaning it leaves the body more quickly so it's better dosed at a lower dose more frequently than at a higher dose less frequently. Started with 100 mg pills every 6-8 hours would be a good choice.

 

If you don't already know, Gabapentin and Tramadol are both human meds and can be purchased quite inexpensively from human pharmacies. I get both from Costco, which is already inexpensive and then they give an additional discount through their pet med program (you have to make sure you sign up for it).

[gryhndens]

She is on Deramaxx 75mg and Tramadol 50mg. I will call tomorrow if she continues to show as much pain as today. Her eating is off schedule as well- she JUST ate dinner.

[a_daerr]

Sounds like the same thing we experienced. My Henry started limping slightly, and within three days, he was not using the leg at all. After the amp surgery, he was very out of it, but he seemed relieved to have the source of the pain gone. OSA is one of the most painful types of cancer... I agree that at this point, getting the pain under control is number one, even if it means increasing her dose or doing a combination of several different pain meds. If I remember correctly, Henry was taking three at one time: Rimadyl (general pain), Tramadol (acute pain), and Gabapentin (nerve pain).

Edited May 21, 2014 by a_daerr

[NeylasMom]

She is on Deramaxx 75mg and Tramadol 50mg. I will call tomorrow if she continues to show as much pain as today. Her eating is off schedule as well- she JUST ate dinner.

Forgive me for being blunt but you need to speak with your vet about increasing meds period. Not her Deramaxx, but her Tramadol and get Gabapentin added in. The typical starting dose for Tramadol for any issue would usually be 50 mg twice per day, 50 mg once per day is nothing.

 

I know I'm not there to see her myself, but everything you are describing indicates her pain is not controlled and the medication regimen she's on combined with her x-rays supports that. Bone cancer is a painful disease. I know you have a lot to process and its incredibly difficult to do so when you're drowning in the emotion that comes with getting this horrible diagnosis, but please get her pain controlled while you sort out what to do.

I wanted to add - I'm stressing this so much because my experience is that you can't adjust meds on a day to day basis based on symptoms. Osteo presents both as ongoing pain and also episodes of breakthrough pain. You really really want to stay ahead of the latter. There's an article linked to in the first post of every osteo thread that talks about this a bit and also discusses the palliative options. It's older now, but still relevant. I recommend reading it if you haven't already.

Again, I'm really sorry you're dealing with this.

[tbhounds]

I agree with adding and increasing pain meds. That dosage of Tramadol you are giving is basically not even close to helping to control the pain. She can receive Tramadol 3 times a day at a lot higher a dose (how much does she weigh)? I would also start gabapentin ASAP.

Edited to add --wanted to give you a dosage example. A 50lb dog could receive 200mgs of Tramadol every 8 hours and a higher dose could actually be given 4 times a day if needed. Of course side effects need to be monitored-specially agitation.

Edited May 21, 2014 by tbhounds

[tbhounds]

I agree with adding and increasing pain meds. That dosage of Tramadol you are giving is basically not even close to helping to control the pain. She can receive Tramadol 3 times a day at a lot higher a dose (how much does she weigh)? I would also start gabapentin ASAP.

Edited to add --wanted to give you a dosage example. A 50lb dog could receive 200mgs of Tramadol every 8 hours and a higher dose could actually be given 4 times a day if needed. Of course side effects need to be monitored-specially agitation.[/quote

Sorry I miss spoke --100mgs of Tramadol every 8 hours. I should know better than try to post from my phone :-)

Edited May 21, 2014 by tbhounds

[EllenEveBaz]

[a_daerr]

Any updates? Her FNA is scheduled for tomorrow, right?

[krissn333]

In my experience, my osteo kids handled tramadol better when it was given in smaller doses but more frequently. 50-100mg every 8 hours worked well for us, as opposed to doing 150-200mg every 12. Less weirdness from the meds that way.

 

Gabapentin is worth its weight in GOLD and made a huge difference in managing pain. Definitely get some of that on hand.

[Guest fastcasper]

Gabapentin is a huge help. My guy was up to 400 mg every 8 hours until his phantom pain was under control, then I backed it down to 300 mg 3x/day for a while with no ill effects on him. I gave him Tramadol 100 mg 3x/day too when he had a soft tissue injury. He weighed about 68-70 lbs.