On Again, Off Again (Mostly Off) Limping

[tbhounds]

Your poor girl. I have to ask--did they get different radiograph views of her shoulder or just a lateral view? Sometimes "things" show up on one view yet not on the other. Exactly what meds is she currently on and when was her last dose given?? Have they mentioned trying robaxin (methocarbamol)?

[jshell]

Your poor girl. I have to ask--did they get different radiograph views of her shoulder or just a lateral view? Sometimes "things" show up on one view yet not on the other. Exactly what meds is she currently on and when was her last dose given?? Have they mentioned trying robaxin (methocarbamol)?

Our first visit produced two radiographs of her front shoulders, side view and underneath. But on the second visit, I know they got another one focusing specifically on the front right shoulder looking for more details because it was obvious that the pain was in that one and the earlier radiographs didn't reveal as much of what was going on.

 

For meds:

- 200mg Gabapentin, twice daily

- 50mg Rimadyl, twice daily

- 50-70 mg Tramadol, 3x daily

 

Last given between 4:30 and 5:30 today.

 

Between 6:30 and 7:00 Betty finally stopped pacing and panting and started to settle down, and is now laying down and resting for long stretches. She seems to move about painfully and starts panting when she gets up, it looks related to the torture her poor legs have gone through with so much pacing about today. But at least she's finally resting. It's sad to see her having worn herself out like that.

Don't think I heard anything about Roboxin, although it may have been mentioned in various phone calls today. Gabapentin itself is new to me.

[tbhounds]

Sounds like they did a pretty good evaluation. They could send the images to boarded radiologist to confirm their diagnosis. The meds she's taking are exactly I would give except you can give the gabapentin every 8 hours too.

I think some of what you were seeing (pacing etc..) was not only due to pain but, she most likely reacted to the buprenex. Most hounds do not do well with opiates but, buprenex does seem to be better tolerated over other narcotics like morphine.

If she needs buprenex again in her future I would recommend a dose for her size would be 1ml (if the concentration is 0.3mgs/ml)--you might want to check the dose she was given recently.

Glad she's starting to settle. I wouldn't hesitate to ask your vet if they feel if robaxin might be of benefit--it's a muscle relaxant --sometimes is just helps to chill the muscle spasms.

Hope she continues to improve. Hope you both get some rest tonight!

[KF_in_Georgia]

Robaxin (methocarbamol) is a muscle relaxer. If she's tensing up every time she feels a twinge of pain, the tensing up may cause more pain, more tensing, more pain, etc. And it can safely be used with tramadol, rimadyl, and gabapentin.

 

Gabapentin may take 48 hours to get up to full strength, and it's safe for her to take a larger dose than the 400mg/day she's getting. Be advised that it wears off in less than 12 hours, too. Perhaps you can stagger some of the meds so that the tramadol is at its strongest when the gabapentin is winding down or something like that. Or maybe her vet will be okay with going up to 200mg every 8 hours.

 

Make sure she eats. Some of these meds really should not land on an empty stomach, so get something into her before she takes the pills. (Much less distressing for both of you than if she takes the pills and then refuses to eat, so that you're risking more trouble.) Elevate her bowl so she doesn't have to stress the shoulder to eat. Tempt her with cooked chicken (no bones). Also, oddly enough, oatmeal is popular in this household. You can make some up in advance, then refrigerate it to cool. My guys love the yucky, cold, congealed stuff. None of these pills taste good. I always rolled them into a piece of turkey lunchmeat and poked that into the dog's mouth. When pills started falling out of the turkey (or the boy started trying to find the pills), I glued them into the meat with a dab of peanut butter. I don't think that fooled my old boy, but he put up with the pills in order to get the PB and turkey.

[jshell]

She finally ate a little bit of canned food tonight, but only a little bit. Better than nothing, I suppose. She seems uninterested in about anything else, including Pill Pockets, which I hope changes soon. Betty also finally seems to be able to lay down and even curl up a bit for long stretches of time and we both got some sleep this evening. Hopefully tomorrow I can schedule a visit with our regular vet and he can see how she's moving about now; it sounds like robaxin could be of benefit. I see a lot of twitching going on, even when laying still.

 

Might it be OK to stagger out the Gabapentin? I only have a fixed amount of it, would it be OK to split the morning/evening dose a couple of hours apart? She gets the 200mg, but maybe spread out the effectiveness of the hours? Or do pills not really work like that?

[KF_in_Georgia]

It will work if you spread out the pills. She'll have a lesser amount of the drug in her system for a while, but at least she'll have some of the drug on board, and if you can time it so the lowest dose of gabapentin is while she has the highest dose of tramadol, that will help. The twitching tonight might be normal--or is she not one of those dogs who runs in her sleep? (I have one quiet sleeper and one who talks and runs marathons in her sleep.)

 

Gabapentin, methocarbamol, and tramadol all can be obtained (with prescriptions) from people pharmacies, usually for less than the vet will charge. Check www.goodrx.com for prices and availability and killer-coupons. (Really. The price for 25mg clomipramine capsules was $600+ for 90 pills; $73 with the coupon.) Rimadyl will be available from your vet or from an on-line pharmacy that does veterinary drugs; it's not a people drug (but it's often listed on goodrx.com also). (I printed coupons from goodrx.com and took them to my vet so he could figure the best way to write the script so I'd get a good price.)

 

If you have a video camera, video Betty getting up or trying to lie down or walking (if her movements are "off" in the morning) or sleeping. Lots of dogs will hide problems while they're at the vet's, so a video of what's happening will be helpful.

 

Don't be surprised that this came on suddenly. Similar trouble started suddenly with my old angel Sam--late on a Friday night. Then he'd be better for a few days, and it would flare up again--on a weekend. Made me crazy. He cried every time he tried to lie down, then yelped as he got back up. After this is cleared up with Betty, expect that it might happen again, and keep drugs on hand or at least a prescription on file at the drug store. Aside from the cheaper price available at a people pharmacy, the hours are better if you need drugs on short notice. And if you get drugs from a chain drug store, you usually can find a 24-hour location in an absolute emergency (like 1am on a weekend morning).

Edited June 12, 2014 by KF_in_Georgia

[jshell]

Happy to say that we both had a restful night and Betty is moving better this morning. She finally ate a meal of canned food, but doesn't seem terribly interested in solids yet. And she's very distrustful of Pill Pockets, which she normally devours in one gulp which might mean having to force her blood pressure meds down her throat for a while too. But it's good to see appetite in her.

 

Her movement is still a bit stiff, but seems related more to her inability to sit/lay down for any sustained length of time yesterday. Even late last night, she looked like an amateur marionette when she tried to walk, and all walking was immediately accompanied by panting. She's not panting like that this morning. So after a long and exhausting day, it's looking much better.

 

Regarding the Buprenex: she was given 0.2mg. Sounds like it was too much for her. I'm not sure if they gave her any during our afternoon visit. She didn't seem quite as stoned as she was after our overnight visit, but the effects just seemed to linger and linger and linger until about 6:30-7:00 last night.

 

Thanks everyone for your help!

[Batmom]

So glad she is better. Hope the improvement continues.

[tbhounds]

Glad she's feeling better!! Regarding the buprenex dose--0.2mgs is a pretty light dose for her size. She just might not be able to handle opiates at all.