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Guest Shermanator

Osteo Pain Management

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Guest Shermanator

Miss Echo was just diagnosed with osteo. We have chosen palliative care for her. She's still her normal self... bouncy, barky, silly, just with a bad limp. Right now she's on tramadol and rimadyl. I noticed the tramadol makes her very lethargic, she's just not herself. We can tell when it wears off, she goes back to her normal self. Do I half the tramadol? How do I tell when its not enough? This is so hard. I'm so sad.

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We just went through this with our lab cross. She was on Percocet which is an usual treatment, Gabapentin and eventually prednizone and tramadol. I would discuss these options with your vet. Hailey had radiation, chemo and a bone building drug, so her situation is likely different from yours. She seemed fairly normal on the Percocet (oxycodone) however.

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Have you checked out the osteo thread...lots of people and hounds with lots of experience (sadly :weep)


Jan with precious pups Katie Crazykatiebug, Emmy (Stormin J Flag) and Simon (Nitro Si) Missing my angels: Bailey Buffetbobleclair 11/11/98-17/12/09; Ben Task Rapid Wave 5/5/02-2/11/15; and Brooke Glo's Destroyer 7/09/06-21/06/16. My blog about grief The reality is that you will grieve forever. You will not get over the loss of a loved one; you will learn to live with it. You will heal and you will rebuild yourself around the loss you have suffered. You will be whole again but you will never be the same. Nor should you be the same, nor would you want to. Elisabeth Kübler-Ross

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Always talk with your vet, but...

 

The most effective pain management seems to be a combo of tramadol, gabapentin and na nsaid (as tolerated). If your girl seems to be a bit onwky on the tramadol dose, see if you can knock it down a little. We always get all the pill in as small a mg as possible to the pain dosage can be customized on an as needed basis. Some days she'll be good and not need as much, and other days you'll need to up it significantly to stay ahead of the pain.

 

Most regular vets are too conservative when treating osteo pain. It's hideous. And they forget you don't have to be concerned over long-term side effects in dogs with cancer. You really do need to keep one step ahead of the pain.

 

If you're doing palliative care, you need to think about and plan ahead for the possibility of a catastrophic break at home. Some vets will prescribe a dose of valium large enough to get the dog to the vet. Know where your e-vet is, and what your options are. It sounds kind of crass, but the more you research and decide now - when you don't have to - the easier it will be in an emergency.


Chris - Mom to: Whiskey (KT's Phys Ed), Lilly, and Felicity ( DeLand )

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Angels: Libby (Everlast), Dorie (Dog Gone Holly), and Dude (TNJ VooDoo), Copper (Kid's Copper), Cash (GSI Payncash), Toni (LPH Cry Baby),

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Give Echo a little time to adjust to the pain meds. When Effie started them, they would make her tired, but now that she has taken them for some time, they don't seem to affect her. I would definitely speak to your vet about adding in the gabapentin.


Effie (Nadine's Effie), Carmen (PHX Downtown), & Benny (the chihuahua)

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Guest Greyt_dog_lover

My vet was very open to my dosage when my girl had osteo. I asked what is the "overdose" amount for each med. I was giving Rymadyl, Gabepentin & Tramadol. I explained to her that I had 2 weeks and had already scheduled a vet to come to the house to help my girl over the bridge on a certain day. My vet understood and said, just keep the dose below "x" amount for each pill. It is understood that massive amounts of the meds will cause damage to both the kidneys and liver as well as stomach, but when you already have the day picked out, it doesnt really matter much anymore, just keep your hound as comfortable as possible. From what I have heard, there is no greater pain than osteo. It sucks, but make the days last. My girl got every piece of junk food possible. Heck, i would give her pills in hostess cupcakes! Thats living.

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Guest Shermanator

Echo starts gabapentin tonight. I know it will make her tired, until it builds up in her system. I just hate seeing my vibrant young lady so worn down by this. Thanks everyone!

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Guest Greyt_dog_lover

one other thing that was amazing to see was acupuncture for the pain. For two days after treatment my girl would act like a pup again. You need to be sure to tell the acupuncturist the location of the osteo as it can speed up the progress of the cancer if they needle the affected areas.

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So sorry you are going through this...

 

When you say "not herself," do you mean that she's restless/agitated/pacing/panting on Tramadol? A lot of greys are sensitive to opiate-based pain meds. It can dilate their pupils and make them appear almost like they're drunk. If that's the case, you can ask your vet to give you another medication, like Valium or Xanax, to combat the feels of restlessness.

 

If she's just sleepy and more or less "out of it," I wouldn't decrease her dose without consulting a vet who has had firsthand experience treating dogs with osteo. OSA is so unbelievably painful. Humans who have experienced it say that it's THE most painful cancer you can have. If you're going with the palliative option, you really have to stay ahead of the pain... even if it means that they don't really act themselves anymore. :(

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the cocktails for pain management are always changing. do talk to your vet and see what else can be done. emily started on metacam and an antiviral that boosted metacam's effects. some tramadol and that held her until the pain was too intense.i didn't want to start in w/ a patch. we managed the pain for almost 6 weeks. but having 20/20 hindsight i now realize that she showed some signs of pain during the late summer- she stopped using her front leg(shoulder was affected) oct. 29th(my bday)- it was her last run. she passed jan 2nd. i am really sad that i let her suffer at all- but that's me.

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Guest Shermanator

Thanks everyone. Echo is on rimadyl, tramadol and gabipentin (sp?). She's barely limping, and back to her normal, silly self!

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